Sample records for major public health

This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a publichealthmajor, and their desire to pursue graduate training in publichealth and subsequently, publichealth careers. The study highlighted the current publichealth workforce shortage and…

Since the 2003 call by the Institute of Medicine to educate undergraduates in publichealth, various models have emerged for incorporating publichealth into the liberal arts and sciences. One model is a professionalized publichealthmajor that uses core publichealth competencies to prepare a workforce of health professionals. A second model offers a broad-based publichealthmajor rooted in liberal arts principles, resisting the utilitarian trend toward human capital formation. A third model resists even the label of "publichealth," preferring instead to introduce undergraduates to many ways of analyzing human health and healing. The multidisciplinary Culture, Health, and Science Program, based on six key commitments for preparing liberal arts students to analyze health and respond to global health challenges, is offered as an alternative to the publichealthmajor.

Vitamin D deficiency is a majorpublichealth problem worldwide in all age groups, even in those residing in countries with low latitude, where it was generally assumed that UV radiation was adequate enough to prevent this deficiency, and in industrialized countries, where vitamin D fortification has been implemented now for years. However, most countries are still lacking data, particularly population representative data, with very limited information in infants, children, adolescents and pregnant women. Since the number of recent publications is escalating, with a broadening of the geographic diversity, the objective of the present report was to conduct a more recent systematic review of global vitamin D status, with particular emphasis in at risk groups. A systematic review was conducted in PubMed/Medline in April-June 2013 to identify articles on vitamin D status worldwide published in the last 10 years in apparently healthy individuals. Only studies with vitamin D status prevalence were included. If available, the first source selected was population-based or representative samples studies. Clinical trials, case-control studies, case reports or series, reviews, validation studies, letters, editorials, or qualitative studies were excluded. A total of 103 articles were eligible and included in the present report. Maps were created for each age group, providing an updated overview of global vitamin D status. In areas with available data, the prevalence of low vitamin D status is a global problem in all age groups, in particular in girls and women from the Middle East. These maps also evidenced the regions with missing data for each specific population groups. There is striking lack of data in infants, children and adolescents worldwide, and in most countries of South America and Africa. In conclusion, vitamin D deficiency is a global publichealth problem in all age groups, particularly in those from the Middle East. PMID:24239505

Since its inception in September 2010, the Network for PublicHealth Law has responded to hundreds of publichealth legal technical assistance claims from around the country. Based on a review of these data, a series of major trends in publichealth practice and the law are analyzed, including issues concerning: the Affordable Care Act, tobacco control, emergency legal preparedness, health information privacy, food policy, vaccination, drug overdose prevention, sports injury law, publichealth accreditation, and maternal breastfeeding. These and other emerging themes in publichealth law demonstrate the essential role of law and practice in advancing the public's health.

The term "crisis" in different cultures (such as ancient Greece or China) can have a positive meaning, since it indicates a time of growth, change and opportunity. Over the centuries there have been times of severe economic and social crisis that led to the implementation of major reforms and improved population health. Nowadays, despite the new economic crisis which has also affected health care for its rising costs, health economics does not hesitate to affirm the importance of key objectives such as prevention and medical assistance. Prevention is not prediction. Prevention means "going upstream" and fixing a problem at the source; the goal is to reduce diseases' effects, causes and risk factors, thereby reducing the prevalence of costly medical conditions.

Administrative datasets can provide information about mental health treatment in real world settings; however, an important limitation in using these datasets is the uncertainty regarding psychiatric diagnosis. To better understand the psychiatric diagnoses, we investigated the diagnostic variability of schizophrenia and major depression in a large public mental health system. Using schizophrenia and major depression as the two comparison diagnoses, we compared the variability of diagnoses assigned to patients with one recorded diagnosis of schizophrenia or major depression. In addition, for both of these diagnoses, the diagnostic variability was compared across seven types of treatment settings. Statistical analyses were conducted using t tests for continuous data and chi-square tests for categorical data. We found that schizophrenia had greater diagnostic variability than major depression (31% vs. 43%). For both schizophrenia and major depression, variability was significantly higher in jail and the emergency psychiatric unit than in inpatient or outpatient settings. These findings demonstrate that the variability of psychiatric diagnoses recorded in the administrative dataset of a large public mental health system varies by diagnosis and by treatment setting. Further research is needed to clarify the relationship between psychiatric diagnosis, diagnostic variability and treatment setting.

Atlanta, GA - Clean diesel grants aimed at cleaning up old diesel engines have greatly improved publichealth by cutting harmful pollution that causes premature deaths, asthma attacks, and missed school and workdays, according to a new report by the

DALLAS - (April 4, 2016) Grants aimed at cleaning up old diesel engines have greatly improved publichealth by cutting harmful pollution that causes premature deaths, asthma attacks, and missed school and workdays, according to a new report by the U

WASHINGTON - Clean diesel grants aimed at cleaning up old diesel engines have greatly improved publichealth by cutting harmful pollution that causes premature deaths, asthma attacks, and missed school and workdays, according to a new report by the

- According to a new report by the U.S. Environmental Protection Agency, clean diesel grants have greatly improved publichealth by cutting harmful pollution that causes premature deaths, asthma attacks, and missed school and workdays.

Around 50% of people, almost all in developing countries, rely on coal and biomass in the form of wood, dung and crop residues for domestic energy. These materials are typically burnt in simple stoves with very incomplete combustion. Consequently, women and young children are exposed to high levels of indoor air pollution every day. There is consistent evidence that indoor air pollution increases the risk of chronic obstructive pulmonary disease and of acute respiratory infections in childhood, the most important cause of death among children under 5 years of age in developing countries. Evidence also exists of associations with low birth weight, increased infant and perinatal mortality, pulmonary tuberculosis, nasopharyngeal and laryngeal cancer, cataract, and, specifically in respect of the use of coal, with lung cancer. Conflicting evidence exists with regard to asthma. All studies are observational and very few have measured exposure directly, while a substantial proportion have not dealt with confounding. As a result, risk estimates are poorly quantified and may be biased. Exposure to indoor air pollution may be responsible for nearly 2 million excess deaths in developing countries and for some 4% of the global burden of disease. Indoor air pollution is a major global publichealth threat requiring greatly increased efforts in the areas of research and policy-making. Research on its health effects should be strengthened, particularly in relation to tuberculosis and acute lower respiratory infections. A more systematic approach to the development and evaluation of interventions is desirable, with clearer recognition of the interrelationships between poverty and dependence on polluting fuels. PMID:11019457

(New York, N.Y.) Clean diesel grants aimed at cleaning up old diesel engines have greatly improved publichealth by cutting harmful pollution that causes premature deaths, asthma attacks, and missed school and workdays, according to a new report by the U.S

Clean diesel grants aimed at cleaning up old diesel engines have greatly improved publichealth by cutting harmful pollution that causes premature deaths, asthma attacks, and missed school and workdays, according to a new report by the U.S. EPA.

In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by publichealth stakeholders in 2013. We review and present the state of knowledge on the publichealth importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely publichealth response.

In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by publichealth stakeholders in 2013. We review and present the state of knowledge on the publichealth importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely publichealth response. PMID:26954882

Antimicrobial resistance (AMR) is mainly sustained by the improper use of antibiotics and has become a global publichealth concern both in the field of human and animal health. Italy has the highest prevalence of AMR among European countries, in particular carbapenem-resistant Klebsiella pneumoniae, which reached 34.3% in 2013. Multidrug-resistant microorganisms' infections are associated with increased risk of complications, higher hospitalization rates, increased healthcare costs, loss of productivity and increased mortality. This paper summarizes the most recent epidemiological data regarding the spread of antibiotic resistance in Italy, consumption and economic impact, outlining the need for timely action and integrated approaches in all countries.

Federal publichealth advisors provide guidance and assistance to health departments to improve publichealth program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering publichealth programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal publichealth advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the PublicHealth Prevention Service, a fellowship program, in 1999; the PublicHealth Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a publichealth agency developing practical skills for program implementation and management.

Background No recent Australian studies or literature, provide evidence of the extent of coverage of multicultural health issues in Australian healthcare research. A series of systematic literature reviews in three major Australian healthcare journals were undertaken to discover the level, content, coverage and overall quality of research on multicultural health. Australian healthcare journals selected for the study were The Medical Journal of Australia (MJA), The Australian Health Review (AHR), and The Australian and New Zealand Journal of PublicHealth (ANZPH). Reviews were undertaken of the last twelve (12) years (1996-August 2008) of journal articles using six standard search terms: 'non-English-speaking', 'ethnic', 'migrant', 'immigrant', 'refugee' and 'multicultural'. Results In total there were 4,146 articles published in these journals over the 12-year period. A total of 90 or 2.2% of the total articles were articles primarily based on multicultural issues. A further 62 articles contained a major or a moderate level of consideration of multicultural issues, and 107 had a minor mention. Conclusions The quantum and range of multicultural health research and evidence required for equity in policy, services, interventions and implementation is limited and uneven. Most of the original multicultural health research articles focused on newly arrived refugees, asylum seekers, Vietnamese or South East Asian communities. While there is some seminal research in respect of these represented groups, there are other communities and health issues that are essentially invisible or unrepresented in research. The limited coverage and representation of multicultural populations in research studies has implications for evidence-based health and human services policy. PMID:20044938

TB incidence in our country is still quite high compared to the average of the European Union countries (1st place among EU countries and 3rd place among WHO European Region countries), which means that a national coordinated response against this disease needs to become the priority of the current health care policy. The multi-factorial conditioning, which includes the social and economic dimensions of TB spreading, requires a multi-disciplinary and inter-sectorial approach to this pathology, going beyond healthcare services. The National Tuberculosis Control Strategy is a part of Romania's Country Strategy based on the guidelines set out in WHO's 2006-2015 Global Plan to Stop Tuberculosis (MDGs 2015) and it provides the necessary framework for refining and harmonizing the national legislation and regulations with the European laws after Romania's integration in the EU.

Salmonella enterica serovar Enteritidis is one of the most common serotypes implicated in Salmonella infections in both humans and poultry worldwide. It has been reported that human salmonellosis is mainly associated with the consumption of poultry products contaminated with serovar Enteritidis. The present study was to extensively analyze the publichealth risk of serovar Enteritidis isolates from chickens in Korea. A total of 127 chicken isolates were collected from clinical cases, on-farm feces, and chicken meat between 1998 and 2012 and 20 human clinical isolates were obtained from patients with diarrhea between 2000 and 2006 in Korea. To characterize the isolates from chickens and humans, we compared the pulsed-field gel electrophoresis (PFGE) patterns and multilocus variable-number tandem-repeat analysis (MLVA) profiles of the isolates. We further characterized representative isolates of different genotypes using a DNA microarray. PFGE revealed 28 patterns and MLVA identified 16 allelic profiles. The DNA microarray showed high genetic variability in plasmid regions and other fimbrial subunits of the isolates although the virulence gene contents of isolates from the same source and/or of the same genotype were unrelated. PFGE and MLVA showed that major genotypes were present in both human and chicken isolates. This result suggests that chickens in Korea pose a significant risk to publichealth as a source of serovar Enteritidis as has been noted in other countries.

Though publichealth situation in Nepal is under-developed, the publichealth education and workforce has not been prioritised. Nepal should institutionalise publichealth education by means of accrediting publichealth courses, registration of publichealth graduates in a data bank and increasing job opportunities for publichealth graduates in various institutions at government sector.

Injury was the largest single cause of disability-adjusted life years and death in the Kingdom of Saudi Arabia in 2013. The vast majority of injury-related fatalities are deaths caused by road traffic. Measures to control this serious publichealth issue, which has significant consequences for both Saudi families and the Saudi economy as a whole, have been underway for years but with little success. Most attempts at intervening revolve around attempts for enforcing stricter traffic laws and by installing automated traffic monitoring systems that will catch law breakers on camera and issue tickets and fines. While there has been much research on various factors that play a role in the high rate of road traffic injury in The Kingdom (e.g., driver behavior, animal collisions, disobeying traffic and pedestrian signals, environmental elements), virtually no attention has been given to examining why Saudi drivers behave the way that they do. This review provides a thorough account of the present situation in Saudi Arabia and discusses how health behavior theory can be used to gain a better understanding of driver behavior. PMID:27747208

Injury was the largest single cause of disability-adjusted life years and death in the Kingdom of Saudi Arabia in 2013. The vast majority of injury-related fatalities are deaths caused by road traffic. Measures to control this serious publichealth issue, which has significant consequences for both Saudi families and the Saudi economy as a whole, have been underway for years but with little success. Most attempts at intervening revolve around attempts for enforcing stricter traffic laws and by installing automated traffic monitoring systems that will catch law breakers on camera and issue tickets and fines. While there has been much research on various factors that play a role in the high rate of road traffic injury in The Kingdom (e.g., driver behavior, animal collisions, disobeying traffic and pedestrian signals, environmental elements), virtually no attention has been given to examining why Saudi drivers behave the way that they do. This review provides a thorough account of the present situation in Saudi Arabia and discusses how health behavior theory can be used to gain a better understanding of driver behavior.

Earth observations can be used to address human health concerns in many ways: projecting occurrence of disease or disease outbreaks; rapid detection and tracking of events; construction of risk maps; targeting interventions; and enhancing knowledge of human health-environment int...

in health were emphasised in the WHO declaration of Alma-Ata, and were the focus of the United Kingdom Black Report. The Jakarta Conference on Health Promotion in 1997 urged international action on poverty, as it is the major threat to health. International acceptance of the need to tackle inequalities took longer than the acceptance of health targets, but it is now an important feature of publichealth policy. The advent of the 21st century marked the coming of age of publichealth. The renewed version of 'Health for All', 'Health for All in the 21st Century', emphasised the one constant goal of WHO that all individuals should achieve their full health potential. Publichealth is now regarded internationally as being a priority with this WHO goal being adopted as the overarching goal of policy. The challenges it faces in tackling problems such as obesity, inequalities in health, smoking, alcohol and substance abuse are great and will require policies which tackle the economic, social and environmental determinants of health.

One of the main interests of the Nordic School of PublicHealth (NHV) in both education and research was child publichealth, i.e. an area based on the broad World Health Organisation (WHO) health ideology and on publichealth methods, while concentrating on the special needs and characteristics of children. The fields of study and action, training, research and service, had the ultimate task to consider the health of children in their full social, economic and political context. Regular courses on child publichealth were offered as part of the general program in PublicHealth from 1979 until the closing down of the school, named: Social Paediatrics; Child Health; Child PublicHealth; and finally, Measuring Children's Health - A PublicHealth Perspective. Numerous national, Nordic and international conferences were held, and several textbooks were written and edited. A major research project, NordChild, was initiated as a cross-sectional postal study of a random sample of children aged 2-17 years from the five Nordic countries, performed in 1984, 1996 and 2011. So far, 10 doctoral theses and more than 130 other publications from the studies have been produced. Furthermore, the Nordic Network on Research of Refugee Children was created, and a special interest has been devoted to indicators for children's health, both internationally, nationally and locally, which has been demonstrated in major EU projects as well as locally in Sweden and Greenland.

Publichealth efforts have resulted in tremendous improvements in the health of individuals and communities. The foundation for effective publichealth interventions rests, in large part, on a well-trained workforce. Unfortunately there is a major shortage of publichealth physicians who are prepared to face today's publichealth challenges.…

Staphylococcus aureus causes numerous mild to severe infections in humans, both in health facilities and in the community. Patients and health care workers (HCWs) may disseminate strains during regular medical examinations or hospitalization. The aim of this study was to determine the nasal carriage rate of methicillin-susceptible and methicillin-resistant S. aureus among health care workers at Hospital Provincial del Centenario, a public general hospital in Rosario, Argentina. A transversal study was conducted on 320 health care workers. Nasal swabs were taken and presumptive S. aureus colonies were isolated. Bacterial identity and methicillin resistance status were confirmed by amplification of the nuc and mec genes. Chi square test and Fisher exact test were used for statistical analysis. Of 320 HCWs, 96 (30%) were nasal carriers of S. aureus, 20 of whom (6.3%) carried methicillin-resistant S. aureus (MRSA) and 76 (23.7%) methicillin-susceptible S. aureus (MSSA). Carriage was within thepublished values for physicians (30%) and higher for technicians (57%). Accompanying resistance (62/96, 64.6%) was detected, including resistance to fluoroquinolones (23/96, 24%), aminoglucosides (13/96, 13.5%) or to macrolides (33/96, 34.4%). All the strains were susceptible to vancomycin whereas only 3.1% (3/96), all of them on MSSA strains, were resistant to mupirocin. This study is the first one of its kind in Argentina and one of the few performed in South America, to highlight the relevance of nasal carriage of MRSA and MSSA in health care personnel and brings to light the need for consensus recommendations for regular S. aureus carriage screening as well as for decolonization strategies.

This article explores public relations effectiveness in publichealth institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

Each year, infection with Human Papillomavirus (HPV) leads to millions of abnormal Pap smears and thousands of cases of cervical cancer in the US. Throughout the developing world, where Pap smears are less common, HPV is a leading cause of cancer death among women. So when the international pharmaceutical giant Merck developed a vaccine that could prevent infection with several key strains of HPV, the publichealth community was anxious to celebrate a major advance. But then marketing and lobbying got in the way. Merck chose to pursue an aggressive lobbying campaign, trying to make its new vaccine mandatory for young girls. The campaign stoked public mistrust about how vaccines come to be mandated, and now it's not just Merck's public image that has taken a hit. The publichealth community has also been affected. What is the lesson to be learned from this story? Publichealth communication relies on public trust.

The rapid spread of a mutant strain of Escherichia coli throughout Europe highlights the need for modern and flexible publichealth laws to identify, control and treat infections and contamination that give significant concern for the health of the population. In this article, Richard Griffith and Cassam Tengnah outline the amendments to the PublicHealth (Control of Disease) Act 1984 that adopt an all-hazards approach to threats to publichealth.

Comprehensive data on the publichealth workforce are fundamental to workforce development throughout the publichealth system. Such information is also a critical data element in publichealth systems research, a growing area of study that can inform the practice of publichealth at all levels. However, methodologic and institutional issues challenge the development of comparable indicators for the federal, state, and local publichealth workforce. A 2006-2007 Association of State and Territorial Health Officials workforce enumeration pilot project demonstrated the issues involved in collecting workforce data. This project illustrated key elements of an institutionalized national system of workforce enumeration, which would be needed for a robust, recurring count that provides a national picture of the publichealth workforce.

This article investigates various ways that transportation policy and planning decisions affect publichealth and better ways to incorporate publichealth objectives into transport planning. Conventional planning tends to consider some publichealth impacts, such as crash risk and pollution emissions measured per vehicle-kilometer, but generally ignores health problems resulting from less active transport (reduced walking and cycling activity) and the additional crashes and pollution caused by increased vehicle mileage. As a result, transport agencies tend to undervalue strategies that increase transport system diversity and reduce vehicle travel. This article identifies various win-win strategies that can help improve publichealth and other planning objectives.

Publichealth law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of publichealth agen cies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for publichealth agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the publichealth system.

Publichealth law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of publichealth agencies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for publichealth agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the publichealth system. PMID:11527757

Environmental PublicHealth Indicators (EPHIs), quantitative measures of health factors and environmental influences tracked over time, can be used to identify specific areas and populations for intervention and prevention efforts and to evaluate the outcomes of implemented polic...

Publichealth, once the gem of American social programs, has turned to dross. During the 20th century, the public-health sector wiped smallpox and polio off the U.S. map; virtually eliminated rickets, rubella, and goiter; stopped epidemic typhoid and yellow fever; and brought tuberculosis--once the leading cause of death in U.S. cities--under…

Thoroughly characterizing and continuously monitoring the publichealth workforce is necessary for ensuring capacity to deliver publichealth services. A prerequisite for this is to develop a standardized methodology for classifying publichealth workers, permitting valid comparisons across agencies and over time, which does not exist for the publichealth workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a publichealth workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all publichealth workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of publichealth workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, publichealth specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection.

Reducing the occurrence of and influencing the rapid correction of food illness risk factors is a common goal for all governmental food regulatory programs nationwide. Foodborne illness in the United States is a major cause of personal distress, preventable illness, and death. To improve publichealth outcomes, additional workforce was required due to long standing staffing shortages and was obtained partially through consolidation of the Hawai‘i Department of Health's (HDOH) two food safety programs, the Sanitation Branch, and the Food & Drug Branch in July 2012, and through legislation that amended existing statutes governing the use of food establishment permit fees. Additionally, a more transparent food establishment grading system was developed after extensive work with industry partners based on three possible placards issued after routine inspections: green, yellow, and red. From late July 2014 to May 2015, there were 6,559 food establishments inspected statewide using the placard system with 79% receiving a green, 21% receiving a yellow, and no red placards issued. Sufficient workforce to allow timely inspections, continued governmental transparency, and use of new technologies are important to improve food safety for the public. PMID:26279966

Little is known about the distribution of eye and vision conditions among school children in Qatar. The aim of the study was to examine the effects of excessive internet use and television viewing on low vision and its prevalence with socio-demographic characteristics. This is a cross-sectional study which was carried out in the public and private schools of the Ministry of Education and Higher Education of the State of Qatar from September 2009 to April 2010. A total of 3200 students aged 6-18 years were invited to take part of whom 2586 (80.8%) agreed. A questionnaire, that included questions about socio-demographic factors, internet use, and television viewing and computer games, co-morbid factors, and family history and vision assessment, was designed to collect information from the students. This was distributed by the school authorities. Of the school children studied (n=2586), 52.8% were girls and 47.2% boys. The overall prevalence of low vision was 15.2%. The prevalence of low vision was significantly higher in the age group 6-10 years (17.1%; P=0.05). Low vision was more prevalent among television viewers (17.2%) than in infrequent viewers (14.0%). The proportion of children wearing glasses was higher in frequent internet users and television viewers (21.3%). Also, low vision without aid was higher in frequent viewers. The study findings revealed a greater prevalence of low vision among frequent internet users and television viewers. The proportion of children wearing glasses was higher among frequent viewers. The prevalence of low vision decreased with increasing age. PMID:28299088

The modern concept of publichealth, the New PublicHealth, carries a great potential for healthy and therefore less aggressive societies. Its core disciplines are health promotion, environmental health, and health care management based on advanced epidemiological methodologies. The main principles of living together in healthy societies can be summarized as four ethical concepts of the New PublicHealth essential to violence reduction equity, participation, subsidiarity, and sustainability. The following issues are discussed as violence determinants: the process of urbanization; type of neighborhood and accommodation, and consequent stigmatization; level of education; employment status; socialization of the family; women's status; alcohol and drug consumption; availability of the firearms; religious, ethnic, and racial prejudices; and poverty. Development of the health systems has to contribute to peace, since aggression, violence, and warfare are among the greatest risks for health and the economic welfare. This contribution can be described as follows: 1) full and indiscriminate access to all necessary services, 2) monitoring of their quality, 3) providing special support to vulnerable groups, and 4) constant scientific and public accountability of the evaluation of the epidemiological outcome. Violence can also destroy solidarity and social cohesion of groups, such as family, team, neighborhood, or any other social organization. Durkheim coined the term anomie for a state in which social disruption of the community results in health risks for individuals. Health professionals can make a threefold contribution to peace by 1) analyzing the causal interrelationships of violence phenomena, 2) curbing the determinants of violence according to the professional standards, and 3) training professionals for this increasingly important task. Because tolerance is an essential part of an amended definition of health, monitoring of the early signs of public intolerance is

Each title has a brief description and link for downloading the full text. Includes the publications catalog, the Child Health Champion resource guide, student curriculum materials, reports, fact sheets, and booklets/brochures of advice and tools.

Major criticisms of health science policy are that (1) health science research is not presently designed to help the public which pays for it; (2) the public should have greater control over health science research; and (3) federal funding of training for health science research is an inappropriate use of tax funds. (Author/DB)

The University of Hawai‘i at Manoa (UHM) has long provided publichealth graduate education. The University's Office of PublicHealth Studies (OPHS) has recently started to offer a Bachelor of Arts in PublicHealth (BA PH) degree in response to the growing need for professionals in the health field. The purpose of this paper is to describe how UHM operates the BA PH and how the program complements OPHS's mission and goals. First, we describe the overall scope of the BA PH within OPHS and within UHM. Then we provide examples of how the BA PH program and past undergraduate student projects align with OPHS's four main goals: (1) education, (2) research, (3) service, and (4) program development. PMID:28352496

Hawai‘i had high insurance coverage rates even before the Affordable Health Care Act and continues to have a high percentage of the population with health insurance today. However, high insurance rates can disguise wide variation in what is covered and what it costs. In this essay, an Australian Masters in PublicHealth student from the University of Hawai‘i considers the strengths and weaknesses of insurance coverage in the US health-care system when her friend “Peter” becomes seriously ill. PMID:27688955

Public-health issues regarding zoological collections and free-ranging wildlife have historically been linked to the risk of transmission of zoonotic diseases and accidents relating to bites or injection of venom or toxins by venomous animals. It is only recently that major consideration has been given worldwide to the role of the veterinary profession in contributing to investigating zoonotic diseases in free-ranging wildlife and integrating the concept of publichealth into the management activities of game preserves and wildlife parks. At the veterinary undergraduate level, courses in basic epidemiology, which should include outbreak investigation and disease surveillance, but also in population medicine, in infectious and parasitic diseases (especially new and emerging or re-emerging zoonoses), and in ecology should be part of the core curriculum. Foreign diseases, especially dealing with zoonotic diseases that are major threats because of possible agro-terrorism or spread of zoonoses, need to be taught in veterinary college curricula. Furthermore, knowledge of the principles of ecology and ecosystems should be acquired either during pre-veterinary studies or, at least, at the beginning of the veterinary curriculum. At the post-graduate level, master's degrees in preventive veterinary medicine, ecology and environmental health, or publichealth with an emphasis on infectious diseases should be offered to veterinarians seeking job opportunities in publichealth and wildlife management.

The strengthening of health systems is fundamental to improving health outcomes, crisis preparedness, and our capacity to meet global challenges, such as accelerating progress towards the Millennium Development Goals, reducing maternal and child mortality, combating HIV, malaria and other diseases, limiting the effects of a new influenza pandemic, and responding appropriately to climate change. To meet these complex needs, the Association of Schools and Programs in PublicHealth, the World Health Organization, and the Institute of Medicine promote systems thinking as the only sensible means to respond to issues that greatly exceed the normal capacity of health and medical services. This paper agrees with the application of systems thinking but argues that health organizations have misunderstood and misapplied systems thinking to the extent that the term has become meaningless. This paper presents the basic constructs of systems thinking, explains why systems thinking has been misapplied, examines some misapplications of systems thinking in health, and suggests how the concept can be applied correctly to medicine and publichealth to achieve the reason it was adopted in the first place. PMID:24377080

Historical assessments of the Occupation’s efforts to tackle enteric diseases (cholera, typhoid, paratyphoid and dysentery) have generally reflected a celebratory narrative of US-inspired publichealth reforms, strongly associated with the head of the PublicHealth and Welfare Section, Crawford F. Sams. Close inspection of the documentary record, however, reveals much greater continuity with pre-war Japanese publichealth practices than has hitherto been acknowledged. Indeed, there are strong grounds for disputing American claims of novelty and innovation in such areas as immunisation, particularly in relation to typhoid vaccine, and environmental sanitation, where disparaging comments about the careless use of night soil and a reluctance to control flies and other disease vectors reveal more about the politics of publichealth reform than the reality of pre-war practices. Likewise, the representation of American-inspired sanitary teams as clearly distinct from and far superior to traditional sanitary associations (eisei kumiai) was closer to propaganda than an accurate rendering of past and present developments. PMID:19048809

This manual supplies information helpful to individuals wishing to become certified in publichealth pest control. It is designed as a technical reference for vector control workers and as preparatory material for structural applicators of restricted use pesticides to meet the General Standards of Competency required of commercial applicators. The…

One of the most fascinating issues in the emerging field of neuroethics is pharmaceutical cognitive enhancement (CE). The three main ethical concerns around CE were identified in a Nature commentary in 2008 as safety, coercion and fairness; debate has largely focused on the potential to help those who are cognitively disabled, and on the issue of 'cosmetic neurology', where people enhance not because of a medical need, but because they want to (as many as 25% of US students already use nootropic cognitive enhancers such as ritalin). However, the potential for CE to improve publichealth has been neglected. This paper examines the prospect of improving health outcomes through CE among sections of the population where health inequalities are particularly pronounced. I term this enhancement of the public's health through CE 'neuroenhancing health'. It holds great promise, but raises several ethical issues. This paper provides an outline of these issues and related philosophical problems. These include the potential effectiveness of CE in reducing health inequalities; issues concerning autonomy and free will; whether moral enhancement might be more effective than CE in reducing health inequalities; and the problem of how to provide such CE, including the issue of whether to provide targeted or universal coverage.

At the dawn of the 21st century, globalisation is a word that has become a part of everyday communication in all corners of the world. It is a concept that for some holds the promise of a new and brighter future, while for others it represents a threat that needs to be confronted and counteracted. In the area of publichealth, a wide range of claims have been made about the various impacts, both positive and negative, that can be attributed to globalisation. In the ever expanding literature on globalisation and health, it has become apparent that considerable confusion is emerging in both the ways that terminology is applied and concepts are defined. The determinants of health are increasingly multisectoral, and in tackling these challenges it is necessary to take a multidisciplinary approach that includes policy analyses in such areas as trade, environment, defence/security, foreign policy, and international law. In assembling the terms for this glossary, we have attempted to demonstrate the richness of the globalisation and publichealth debate, and in so doing have selected some of the core terms that require definition. We hope that this glossary will help to clarify this interesting and challenging area, and will also serve as a useful entry point to this new debate in publichealth.

Nanotechnology is developing very quickly, and Japan is in many respects leading the world in this convergence of nanoscale engineering techniques. The publichealth community in Japan must start to think about the publichealth impacts of nanotechnology over the next 20 years. The responsibility for the benefits and the harms of nanotechnology lies with government, with corporations and the business community, with scientists and specialists in all related fields, and with NPOs and the public. There are very many questions of publichealth which are not yet being asked about nanotechnology. If nanoparticles are to be used in cosmetics, food production and packaging, how will they react or interact with the human skin and organs? What chemical-toxic effects on life might there be from the nanoparticles in car tires and vehicle plastic mouldings when they are disposed of by incineration? Will they pass into the soil and groundwater and enter into the food-chain? It is now an urgent ethical demand, based on the precautionary principle, that Japan join the governments of the world to take an intergovernmental initiative to intervene in the further development, production and marketing of nanotechnological products with precautionary research and regulation.

The importance of law in the organization and operation of publichealth systems has long been a matter of interest to publichealth lawyers and practitioners, but empirical research on law as a factor in health system performance has been limited in quantity and sophistication. The emergence of PublicHealth Law Research and PublicHealth Systems and Services Research within a coordinated effort to strengthen publichealth research and practice has dramatically changed matters. This article introduces PublicHealth Law Research as an integral part of PublicHealth Systems and Services Research, discusses the challenges of integrating the 2 fields, and highlights 2 examples of current research that demonstrate the benefits of an integrated approach to improve the use of law in publichealth practice.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a proven, cost-effective investment in strengthening families. As part of the United States Department of Agriculture's (USDA) 15 federal nutrition assistance programs for the past 40 years, WIC has grown to be the nation's leading publichealth nutrition program. WIC serves as an important first access point to health care and social service systems for many limited resource families, serving approximately half the births in the nation as well as locally. By providing nutrition education, breastfeeding promotion and foods in addition to referrals, WIC plays a crucial role in promoting lifetime health for women, infants and children. WIC helps achieve national publichealth goals such as reducing premature births and infant mortality, increasing breastfeeding, and reducing maternal and childhood overweight. Though individuals and families can self-refer into WIC, physicians and allied health professionals have the opportunity and are encouraged to promote awareness of WIC and refer families in their care. PMID:25285258

Chronically understaffed publichealth laboratories depend on a decreasing number of employees who must assume broader responsibilities in order to sustain essential functions for the many clients the laboratories support. Prospective scientists considering a career in publichealth are often not aware of the requirements associated with working in a laboratory regulated by the Clinical Laboratory Improvement Amendments (CLIA). The purpose of this pilot internship was two-fold; introduce students to operations in a regulated laboratory early enough in their academics so that they could make good career decisions, and evaluate internship methodology as one possible solution to workforce shortages. Four interns were recruited from three different local universities, and were paired with an experienced State Laboratories Division (SLD) staff mentor. Students performed tasks that demonstrated the importance of CLIA regulations for 10–15 hours per week over a 14 week period. Students also attended several directed group sessions on regulatory lab practice and quality systems. Both interns and mentors were surveyed periodically during the semester. Surveys of mentors and interns indicated overall positive experiences. One-on-one pairing of experienced publichealth professionals and students seems to be a mutually beneficial arrangement. Interns reported that they would participate if the internship was lower paid, unpaid, or for credit only. The internship appeared to be an effective tool to expose students to employment in CLIA-regulated laboratories, and potentially help address publichealth laboratory staffing shortfalls. Longer term follow up with multiple classes of interns may provide a more informed assessment. PMID:23386992

The Hawai‘i Maternal and Infant Health Collaborative, founded in 2013, is a public-private partnership committed to improving birth outcomes and reducing infant mortality. The Collaborative was developed in partnership with the Executive Office on Early Learning Action Strategy with help from the Department of Health and National Governor's Association. The Action Strategy provides Hawai‘i with a roadmap for an integrated and comprehensive early childhood system, spanning preconception to third grade. The Collaborative helps advance goals within the Action Strategy by focusing on ensuring that children have the best start in life by being healthy and welcomed. The Collaborative has completed a strategic plan and accompanying Logic Model, The First 1,000 Days, aimed at achieving the outcomes of 8% reduction in preterm births and 4% reduction in infant mortality. To date over 120 people across Hawai‘i have been involved in the Collaborative. These members include physicians and clinicians, publichealth planners and providers, insurance providers and health care administrators. The work is divided into three primary areas and coordinated by a cross sector leadership team. Work is specific, outcome driven, informed by data and primarily accomplished in small work groups. PMID:27738566

Canada has a diverse population of 32 million people and a universal, publicly funded health care system provided through provincial and territorial health insurance plans. Publichealth activities are resourced at provincial/territorial level with strategic coordination from national bodies. Canada has one of the longest-standing genetics professional specialty organizations and is one of the few countries offering master's level training designed specifically for genetic counselors. Prenatal screening is offered as part of routine clinical prenatal services with variable uptake. Surveillance of the effect of prenatal screening and diagnosis on the birth prevalence of congenital anomalies is limited by gaps and variations in surveillance systems. Newborn screening programs vary between provinces and territories in terms of organization and conditions screened for. The last decade has witnessed a four-fold increase in requests for genetic testing, especially for late onset diseases. Tests are performed in provincial laboratories or outside Canada. There is wide variation in participation in laboratory quality assurance schemes, and there are few regulatory frameworks in Canada that are directly relevant to genetics testing services or population genetics. Health technology assessment in Canada is conducted by a diverse range of organizations, several of which have produced reports related to genetics. Several large-scale population cohort studies are underway or planned, with initiatives to harmonize their conduct and the management of ethical issues, both within Canada and with similar projects in other countries.

Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Publichealth brands are the associations that individuals hold for health behaviors, or lifestyles that embody multiple health behaviors. We systematically reviewed the literature on publichealth brands; developed a methodology for describing branded health messages and campaigns; and examined specific branding strategies across a range of topic areas, campaigns, and global settings. We searched the literature for published studies on publichealth branding available through all relevant, major online publication databases. Publichealth branding was operationalized as any manuscripts in the health, social science, and business literature on branding or brands in health promotion marketing. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 154 articles and reviewed a final set of 37, 10 from Africa, Australia, and Europe. Branded health campaigns spanned most of the major domains of publichealth and numerous communication strategies and evaluation methodologies. Most studies provided clear information on planning, development, and evaluation of the branding effort, while some provided minimal information. Branded health messages typically are theory based, and there is a body of evidence on their behavior change effectiveness, especially in nutrition, tobacco control, and HIV/AIDS. More rigorous research is needed, however, on how branded health messages impact specific populations and behaviors.

An undestanding of the activities and functions of a speech therapist within the specific context of the Basic Health Units (Unidades Básicas de Saúde) is sought. Difficulties relating to the introduction of a new service on the basis of one of the health professions that has not hitherto belonged to the group of categories which are traditionally incorporated in these same Basic Units. When the statistical data on the demand for speech therapy services by the population who attend health centres were considered, it was discovered that 32% were of schooling age and had been referred by schools, allegedly due to "learning problems". Closer contact with these children, through speech therapy, has brought a different aspect to light i.e. that one cannot consider as disturbance/deviation/problem/pathology written signs which constitute indications of the shock between the process of literacy and that of learning how to read and write. To understand the problem from the point of view of publichealth, a programme of teacher counselling is proposed, with the purpose of helping the school to clarify its role as co-constructor of the child's literacy process and of returning to the teacher the responsibility for the success and/or failure of teaching how to read and write. A similar programme is proposed for creches where coincidently, a greater proportion (44%) of the younger children (2 to 5 years of age) are seen to have difficulties in oral language development.(ABSTRACT TRUNCATED AT 250 WORDS)

This paper sketches an account of publichealth ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in publichealth ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of publichealth, from policy making through to programme delivery. The complexity of publichealth demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of publichealth ethics embraces rather than avoids the inescapable political dimensions of publichealth.

Exposure to noise constitutes a health risk. There is sufficient scientific evidence that noise exposure can induce hearing impairment, hypertension and ischemic heart disease, annoyance, sleep disturbance, and decreased school performance. For other effects such as changes in the immune system and birth defects, the evidence is limited. Most publichealth impacts of noise were already identified in the 1960s and noise abatement is less of a scientific but primarily a policy problem. A subject for further research is the elucidation of the mechanisms underlying noise-induced cardiovascular disorders and the relationship of noise with annoyance and nonacoustical factors modifying health outcomes. A high priority study subject is the effects of noise on children, including cognitive effects and their reversibility. Noise exposure is on the increase, especially in the general living environment, both in industrialized nations and in developing world regions. This implies that in the twenty-first century noise exposure will still be a majorpublichealth problem. Images Figure 2 PMID:10698728

The approach of a millennial passage invites publichealth to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new publichealth" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and publichealth professionals. PMID:1746649

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial publichealth interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health – an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Publichealth policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear publichealth benefits. PMID:25995305

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial publichealth interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health - an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Publichealth policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear publichealth benefits.

Healthy Mothers, Healthy Babies Coalition of Hawai‘i (HMHB) is a local nonprofit organization dedicated to eliminating health disparities and improving Hawai‘i's maternal, child, and family health though collaborative efforts in public education, advocacy, and partner development. A review of HMHB services revealed overwhelming requests for both breastfeeding and postpartum depression (PPD) support. The purpose of this article is to present the findings of two surveys that highlight the awareness of existing breastfeeding and PPD resources based on both parents and health care providers; perceptions of where and how care is accessed; and whether mothers throughout Hawai‘i have equitable access to support. Results helped assess gaps in resources and determine barriers to care, as well as provide suggestions for new services or resources. Web-based surveys were sent to 450 providers and 2,955 parents with response rates of 8.9% and 4.0%, respectively. Less than half of parent participants reported that their health provider discussed PPD with them. Participants identified a number of barriers to increasing access and utilization of PPD support resources, including: not feeling like symptoms were server enough, feeling embarrassed to seek help, not knowing where to find support/information, and not able to afford or insurance wouldn't cover PPD support. Only 40% of providers reported screening for PPD and 33% felt they had not received adequate training. Barriers identified by providers were a lack of trained providers, lack of PPD specific support groups, cultural stigma, and lack of PPD awareness among providers. Of the women who did not exclusively breastfeed for the full six-month recommendation, the most common breastfeeding concerns included: perceptions of low milk supply; lack of lactation support; medical reasons; and pain. Providers described an environment of uneven distribution of resources, general lack of awareness of available resources, along

This report documents issues related to the work of the Florida Comprehensive Health Professions Education Plan. Publichealth education prepares students for initial employment or advancement in a number of positions. While the publichealth work force is primarily employed in various units in local, state, and federal governments, industry also…

provide a strong concept of the publichealth infrastructure. It is a useful tool permitting local agencies to compare themselves to national averages...limitations of the system they govern. The concept of articulating program guidelines for local publichealth activities is a NJDHSS tradition...referral to treatment and social service agencies. • Maternal and Child Health activities a. Infants and preschool – health supervision for infants

The Centers for Disease Control and Prevention Office of Workforce and Career Development is committed to developing a competent, sustainable, and diverse publichealth workforce through evidence-based training, career and leadership development, and strategic workforce planning to improve population health outcomes. This article reviews the previous efforts in identifying priorities of publichealth workforce research, which are summarized as eight major research themes. We outline a strategic framework for publichealth workforce research that includes six functional areas (ie, definition and standards, data, methodology, evaluation, policy, and dissemination and translation). To conceptualize and prioritize development of an actionable publichealth research agenda, we constructed a matrix of key challenges in workforce analysis by publichealth workforce categories. Extensive reviews were conducted to identify valuable methods, models, and approaches to publichealth workforce research. We explore new tools and approaches for addressing priority areas for publichealth workforce and career development research and assess how tools from multiple disciplines of social sciences can guide the development of a research framework for advancing publichealth workforce research and policy.

Avoidable patient harm is a majorpublichealth concern, and may already have surpassed heart disease as the leading cause of death in the United States. While the publichealth community has contributed much to one aspect of patient harm prevention, infection control, the tools and techniques of publichealth have far more to offer to the emerging field of patient safety science. Patient safety practice has become increasingly professionalized in recent years, but specialist degree programs in the field remain scarce. Healthcare organizations should consider graduate training in publichealth as an avenue for investing in the professional development of patient safety practitioners, and schools and programs of publichealth should support further research and teaching to support patient safety improvement.

Law has been an essential tool of publichealth practice for centuries. From the 19th century until recent decades, however, most histories of publichealth described, approvingly, the progression of the field from marginally useful policy, made by persons learned in law, to effective policy, made by persons employing the methods of biomedical and behavioral science. Historians have recently begun to change this standard account by documenting the centrality of law in the development of publichealth practice. The revised history of publichealth offers additional justification for the program of publichealth law reform proposed in this issue of the Journal by Gostin and by Moulton and Matthews, who describe the new program in publichealth law of the Centers for Disease Control and Prevention. PMID:11527756

Social marketing, the use of marketing to design and implement programs to promote socially beneficial behavior change, has grown in popularity and usage within the publichealth community. Despite this growth, many publichealth professionals have an incomplete understanding of the field. To advance current knowledge, we provide a practical definition and discuss the conceptual underpinnings of social marketing. We then describe several case studies to illustrate social marketing's application in publichealth and discuss challenges that inhibit the effective and efficient use of social marketing in publichealth. Finally, we reflect on future developments in the field. Our aim is practical: to enhance publichealth professionals' knowledge of the key elements of social marketing and how social marketing may be used to plan publichealth interventions.

The Asian tiger mosquito Stegomyia albopicta (= Aedes albopictus) (Diptera: Culicidae), native to Asian forests, is a nuisance mosquito and is responsible for the transmission of arboviruses of publichealth importance, such as dengue, chikungunya and Zika viruses. It has colonized parts of all continents, except Antarctica, over the past 30-40 years. However, to date, the only records of S. albopicta in North Africa refer to occasional collections in 2010 and 2014 in Algeria. In early September 2015, S. albopicta larvae and adults were collected in a district of Rabat, Morocco. Morphological identification was confirmed by molecular analysis. This is the first record of this invasive mosquito in Morocco. A national surveillance programme will be implemented in 2016 to establish its geographical distribution in Morocco and to instigate control measures to prevent the establishment of new populations and the transmission of arboviruses.

Today the terrorism is a problem of global distribution and increasing interest for the international publichealth. The terrorism related violence affects the publichealth and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and publichealth, focusing on its effects on publichealth and the health care services, as well as to examine the possible frames to face the terrorism as a publichealth concern, with special reference to the situation in Spain. To face this problem, both the publichealth systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the publichealth laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

Principles of active learning were used to design and implement an introductory publichealth course. Students were introduced to the breadth and practice of publichealth through team and individual-based activities. Team assignments covered topics in epidemiology, biostatistics, health behavior, nutrition, maternal and child health, environment, and health policy. Students developed an appreciation of the population perspective through an "experience" trip and related intervention project in a publichealth area of their choice. Students experienced several key critical component elements of a publichealth undergraduate major; they explored key publichealth domains, experience publichealth practice, and integrated concepts with their assignments. In this paper, course assignments, lessons learned, and student successes are described. Given the increased growth in the undergraduate publichealthmajor, these active learning assignments may be of interest to undergraduate publichealth programs at both liberal arts colleges and research universities.

Principles of active learning were used to design and implement an introductory publichealth course. Students were introduced to the breadth and practice of publichealth through team and individual-based activities. Team assignments covered topics in epidemiology, biostatistics, health behavior, nutrition, maternal and child health, environment, and health policy. Students developed an appreciation of the population perspective through an “experience” trip and related intervention project in a publichealth area of their choice. Students experienced several key critical component elements of a publichealth undergraduate major; they explored key publichealth domains, experience publichealth practice, and integrated concepts with their assignments. In this paper, course assignments, lessons learned, and student successes are described. Given the increased growth in the undergraduate publichealthmajor, these active learning assignments may be of interest to undergraduate publichealth programs at both liberal arts colleges and research universities. PMID:25566526

Legally, governments use their police powers to protect publichealth, safety, and welfare through zoning. This paper presents a case for revisiting zoning on the basis of increasing evidence that certain types of community design promote publichealth, as opposed to the dominant pattern of sprawl development, which does not. Zoning, and the land use planning linked to it, that prohibits or disfavors health-promoting community designs contradicts the inherent public policy goal on which it is based. If there is a paradigm shift underway, from traditional sprawl to health-promoting community designs, then health professionals and others should understand why zoning must be reassessed.

The precautionary principle has provoked a spirited debate among environmentalists worldwide, but it is equally relevant to publichealth and shares much with primary prevention. Its central components are (1) taking preventive action in the face of uncertainty; (2) shifting the burden of proof to the proponents of an activity; (3) exploring a wide range of alternatives to possibly harmful actions; and (4) increasing public participation in decision making. Precaution is relevant to publichealth, because it can help to prevent unintended consequences of well-intentioned publichealth interventions by ensuring a more thorough assessment of the problems and proposed solutions. It can also be a positive force for change. Three aspects are stressed: promoting the search for safer technologies, encouraging greater democracy and openness in publichealth policy, and stimulating reevaluation of the methods of publichealth science. PMID:11527753

Many publichealth dilemmas involve a tension between the promotion of health and the rights of individuals. This article suggests that we should resolve the tension using our familiar liberal principles of government. The article considers the common objections that (i) liberalism is incompatible with standard publichealth interventions such as anti-smoking measures or intervention in food markets; (2) there are special reasons for hard paternalism in publichealth; and (3) liberalism is incompatible with proper protection of the community good. The article argues that we should examine these critiques in a larger methodological framework by first acknowledging that the right theory of publichealth ethics is the one we arrive at in reflective equilibrium. Once we examine the arguments for and against liberalism in that light, we can see the weaknesses in the objections and the strength of the case for liberalism in publichealth.

The PublicHealth Programs and Services (PHP&S) Branch of the Los Angeles County Department of Health Services began a strategic planning effort in January 1986 to meet new disease trends, curb rising health care costs, consolidate limited resources, and handle shifting demographics. A strategic plan was designed to assess the opportunities and challenges facing the agency over a 5-year horizon. Priority areas were recognized, and seven strategic directives were formulated to guide PHP&S in expanding publichealth services to a changing community. Health promotion was acknowledged as a critical target of the strategic planning process. Among the most significant results of the health promotion directive was the establishment of an annual PublicHealth Week in Los Angeles County. Beginning in 1988, 1 week per year was selected to enhance the community's awareness of publichealth programs and the leadership role PHP&S plays in providing these programs to nearly 9 million residents of Los Angeles County. Events in PublicHealth Week include a professional lecture series and the honoring of an outstanding publichealth activist and a media personality who has fostered health promotion. Other free community activities such as mobile clinics, screenings, and health fairs are held throughout the county. With intensive media coverage of PublicHealth Week, PHP&S has been aggressive in promoting its own services and accomplishments while also educating the community on vital wellness issues. The strategic methodology employed by PHP&S, with its emphasis on long-range proactive planning, is receiving national recognition and could be adopted by similar agencies wishing to enhance their image and develop unique health promotion projects in their communities.

Though not necessarily using the same terminology historically, people concerned with the public's health have long been addressing the social context of non-communicable diseases (NCDs) and the actions of promoting health. This commentary places the current interest in NCDs within that history and discusses the challenges that continue to face institutions in dealing with NCDs. It makes a particular plea for the role of health promotion as the area of publichealth that takes actions to address the global burden of NCDs. Without a health promotion focus, we will just continue to describe the NCD burden rather than reduce it.

Italy's recent economic growth and strategic position in the Mediterranean Sea have made it a prime destination for immigrants and asylum seekers in Europe. Despite its well-developed health care system, statistics on foreign citizens' health are worrisome. In 1998 publichealth services were extended to illegal immigrants, giving them the right to necessary urgent and non-urgent medical assistance, even for a prolonged period. This paper examines a two-year joint intervention project between Centre for the Study and Research of PublicHealth (Mental Health), Local Health Agency ROMA E (LHA RME) and the non-governmental organization Médecins Sans Frontières (MSF) in Rome.

The Financial Statistics of MajorPublicly Owned Electric Utilities publication presents summary and detailed financial accounting data on the publicly owned electric utilities. The objective of the publication is to provide Federal and State governments, industry, and the general public with data that can be used for policymaking and decisionmaking purposes relating to publicly owned electric utility issues.

The purpose of this national study was to determine advocacy activities and level of involvement of health commissioners regarding public policy. Benefits, barriers, and perceived outcomes of advocacy efforts were also explored. A previously validated (Holtrop et al., Am J Health Behav 24(2):132-142, 2000) four-page survey was mailed to 700 health commissioners, who were randomly selected from the National Association of County and City Health Officials (NACCHO) database. A three-wave mailing was performed which yielded a 50% response rate. Of these respondents, the majority (70%) were female and (88%) Caucasian. Overall, 31% of health commissioners reported being involved in influencing public policy in the last 4 years. The most common reported activities engaged in by health commissioners included voting (84%), and providing policy information to consumers or other professionals (77%). Perceived barriers to influencing policy were time, (64%), and other priorities (46%). Perceived benefits to influencing policy included improving the health of the public (94%) and making a difference in others' lives (87%). Only 15% perceived their knowledge regarding the process of changing public policy was excellent. Although health commissioners are often spokespersons for health agencies and communities, their public policy involvement is marginal. Professional preparation programs and continuing education opportunities should focus on advocacy, public policy development, and removing barriers to action.

Dental publichealth is one of the nine specialties of dentistry recognized by the American Dental Association Commission on Dental Accreditation. Dental publichealth has been defined as the "science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than as an individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis." This article will describe the many career and educational pathways dentists may follow to become irvolved in the practice of dental publichealth.

The Turning Point Model State PublicHealth Act (Turning Point Act), published in September 2003, provides a comprehensive template for states seeking publichealth law modernization. This case study examines the political and policy efforts undertaken in Alaska following the development of the Turning Point Act. It is the first in a series of case studies to assess states' consideration of the Turning Point Act for the purpose of publichealth law reform. Through a comparative analysis of these case studies and ongoing legislative tracking in all fifty states, researchers can assess (1) how states codify the Turning Point Act into state law and (2) how these modernized state laws influence or change publichealth practice, leading to improved health outcomes.

The 1993 edition of the Financial Statistics of Major U.S. Publicly Owned Electric Utilities publication presents five years (1989 to 1993) of summary financial data and current year detailed financial data on the majorpublicly owned electric utilities. The objective of the publication is to provide Federal and State governments, industry, and the general public with current and historical data that can be used for policymaking and decision making purposes related to publicly owned electric utility issues. Generator and nongenerator summaries are presented in this publication. The primary source of publicly owned financial data is the Form EIA-412, the Annual Report of Public Electric Utilities, filed on a fiscal basis.

Objective: The article explores the characteristics of publichealth information needs and the resources available to address those needs that distinguish it as an area of searching requiring particular expertise. Methods: Publichealth searching activities from reference questions and literature search requests at a large, urban health department library were reviewed to identify the challenges in finding relevant publichealth information. Results: The terminology of the information request frequently differed from the vocabularies available in the databases. Searches required the use of multiple databases and/or Web resources with diverse interfaces. Issues of the scope and features of the databases relevant to the search questions were considered. Conclusion: Expert searching in publichealth differs from other types of expert searching in the subject breadth and technical demands of the databases to be searched, the fluidity and lack of standardization of the vocabulary, and the relative scarcity of high-quality investigations at the appropriate level of geographic specificity. Health sciences librarians require a broad exposure to databases, gray literature, and publichealth terminology to perform as expert searchers in publichealth. PMID:15685281

This article uses the concept of anomie for understanding public mental-health issues and constructing strategies aimed at promoting health and preventing disease. Studying anomie involves many definitions and approaches; this article conceptualises anomie as dérréglement or derangement and as a total social fact as its effects and consequences are pervasive across all areas of human experience. The article suggests the pertinence of the concept to publichealth based on several authors' observations depicting Latin-America as being a set of anomic societies and Colombia as the extreme case. Current definitions of mental health in positive terms (not just as being the absence of mental illness) validate the need for considering anomie as an indicator of public mental health. The article proposes that if anomie expresses itself through rules as basic social structure components, then such rules should also be considered as the point of intervention in promoting mental health.

Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect publichealth, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization’s General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Publichealth professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and publichealth deserve more attention than they have received to date. PMID:15623854

Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect publichealth, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization's General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Publichealth professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and publichealth deserve more attention than they have received to date.

Tsunamis have the potential to cause an enormous impact on the health of millions of people. During the last half of the twentieth century, more people were killed by tsunamis than by earthquakes. Most recently, a major emergency response operation has been underway in northeast Japan following a devastating tsunami triggered by the biggest earthquake on record in Japan. This natural disaster has been described as the most expensive in world history. There are few resources in the publichealth literature that describe the characteristics and epidemiology of tsunami-related disasters, as a whole. This article reviews the phenomenology and impact of tsunamis as a significant publichealth hazard.

Justice is so central to the mission of publichealth that it has been described as the field's core value. This account of justice stresses the fair disbursement of common advantages and the sharing of common burdens. It captures the twin moral impulses that animate publichealth: to advance human well-being by improving health and to do so particularly by focusing on the needs of the most disadvantaged. This Commentary explores how social justice sheds light on major ongoing controversies in the field, and it provides examples of the kinds of policies that publichealth agencies, guided by a robust conception of justice, would adopt.

The report into the outbreak of measles in the Swansea area in 2013 has recommended that publichealth law be used as a routine response to minimising the spread of infectious diseases. In this article, the author considers what powers are available to health and local authorities to minimise the spread of an infectious disease outbreak.

... publichealth by providing a variety of comprehensive classroom and curriculum resources. Framing The Future Faculty Resources ... and is regularly spotlighted in popular culture and media . The impact is measurable. In the past century, ...

Marketing techniques and tools, imported from the private sector, are increasingly being advocated for their potential value in crafting and disseminating effective social change strategies. This paper describes the field of social marketing as it is used to improve the health of the public. A disciplined process of strategic planning can yield promising new insights into consumer behavior and product design. But the "technology" cannot simply be transferred without some translation to reconcile differences between commercial marketing and publichealth.

Chinese Americans constitute the largest percentage of Asian Americans. In Hawai‘i, Chinese Americans make up approximately 4.7% of the total state population. Accurately assessing health disparities across specific Asian American subgroups is critically important to health research and policy, as there is often substantial variability in risk and outcomes. However, even for Chinese Americans, the largest of the Asian American subgroups, such analyses can present challenges in population-based surveys. This article considers these challenges generally and then specifically in terms of the issue of health literacy and heart disease in Chinese Americans using existing population-based survey data sets in the United States, California, and Hawai‘i. PMID:28090401

Encouraged by the success of smoking denormalization strategies as a tobacco-control measure, publichealth institutions are adopting a similar approach to other health behaviors. For example, a recent controversial ad campaign in New York explicitly aimed to denormalize HIV/AIDS amongst gay men. Authors such as Scott Burris have argued that efforts like this are tantamount to stigmatization and that such stigmatization is unethical because it is dehumanizing. Others have offered a limited endorsement of denormalization/stigmatization campaigns as being justified on consequentialist grounds; namely, that the potential publichealth benefits outweigh any stigmatizing side effects. In this paper, I examine and reject the blanket condemnation of stigmatization efforts in publichealth. I argue that the moral status of such efforts are best evaluated within a contractualist, as opposed to a consequentialist, framework. Contractualism in publichealth ethics asks whether a particular stigmatizing policy could be justified to reasonable individuals who do not know whether they will be affected by that policy. Using this approach, I argue that it is sometimes permissible for publichealth institutions to engage in health-related stigmatization.

Oral diseases are a majorpublichealth problem, and their burden is on increase in many low- and middle-income countries. Dental publichealth (DPH) aims to improve the oral health of the population through preventive and curative services. However, its achievements in India are being questioned probably because of lack of proficiency and skill among DPH personnel. The literature search for the present study was conducted utilizing various search engines and electronic databases such as PubMed and MEDLINE. Documents related to the Central and State Governments of India were also considered. Finally, 26 articles were selected for the present study from which relevant information can be extracted. The present study focuses on some of the important aspects relating to DPH in India such as priority for oral health, DPH workforce and curriculum, utilization of DPH personnel in providing primary oral health care, role of mobile dental vans, and research in DPH. It was concluded that more attention should be given toward preventive oral health care by employing more number of publichealth dentists in public sector, strengthening DPH education and research, and combining oral health programs with general health-care programs. PMID:28348984

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Substance use can have serious consequences for the health and well-being of individuals. The problem is of particular concern when it involves pregnant women due to health risks for the mother and the fetus. In utero exposure to either legal (eg, alcohol, cigarettes, and certain prescription drugs) or illicit (eg, amphetamines, cocaine, and opioids) substances can result in potentially serious and long-lasting health problems for infants. Available data from Hawai‘i indicate that substance use among pregnant women is higher than national targets, which reflect the fact that there is essentially no acceptable rate of use of these substances. Developing an effective system to support virtual elimination of substance use in pregnancy requires broad-based strategies. Progress is being made in Hawai‘i to better identify and address substance use in pregnancy. These efforts are being guided by a variety of stakeholders who are dedicated to improving the healthcare and health outcomes for this population. However, significant challenges to the system remain, including provider shortages, lack of local investment, and limited capacity of appropriate, individualized treatment. PMID:27920946

Studies on the health effects of disasters have shown that epidemiological indices can be of value in planning preventive and relief measures and in evaluating their effectiveness. Mortality rates naturally vary considerably, but in earthquakes, for example, the number of deaths per 100 houses destroyed can give an indication of the adequacy of building techniques. Age-specific mortality rates can help to identify particularly vulnerable groups and perhaps indicate what form of education would be valuable. Except in earthquakes, the number of casualties after a disaster is usually low in relation to the number of deaths, and study of the distribution and types of lesions would help in planning the amounts and types of relief supplies and personnel required. Disasters also affect the general level of morbidity in a district because of either interruption of normal health care services or of spraying or other disease control measures. Mental health and nutrition following disasters are particular problems that require further investigation. Study of all these features of disasters has been handicapped by a lack of data, particularly concerning the health situation immediately after the impact. The provision of surveillance teams in disaster-prone areas would appear to be a field in which international cooperation could yield immense benefits. PMID:311707

Home visiting services are cost-effective and improve the health of children and families among those at increased risk. From 1985–2008, home visiting services in Hawai‘i were provided primarily through state funding of the Hawai‘i Healthy Start Program, but the program was severely reduced due to the economy and state budget changes over the past decade. The Maternal and Child Health Branch (MCHB) in the Family Health Services Division responded to these changes by seeking out competitive grant opportunities and collaborations in order to continue to promote home visiting services to those children and families in need. In 2010, the MCHB was awarded a federally funded Maternal, Infant and Early Childhood Home Visiting (MIECHV) grant for home visiting services to promote maternal, infant, and early childhood health, safety and development, strong parent-child relationships, and responsible parenting. In 2011, the MCHB was also awarded a competitive MIECHV development grant that funded the re-establishment of the hospital Early Identification program. Families in need of additional support identified through this program are referred for family strengthening services to a network of existing home visiting programs called the Hawai‘i Home Visiting Network (HHVN). The HHVN is supported by MIECHV and a small amount of state funds to assist programs with capacity building, training, professional development, quality assurance, and accreditation/certification support. The MIECHV grant requires that programs are evidence-based and address specific outcome measures and benchmarks. The HHVN provides home visiting services to families prenatally through 5 years of age that reside in specific at-risk communities, and is aimed at fostering positive parenting and reducing child maltreatment using a strength-based approach by targeting six protective factors: (1) social connections, (2) nurturing and attachment, (3) knowledge of parenting and child development, (4

Human health so often depends on the health of the environment and wildlife around us. The presence of naturally occurring or human environmental contaminants and the emergence of diseases transferred between animals and humans are growing concerns worldwide. The USGS is a source of natural science information vital for understanding the quantity and quality of our earth and living resources. This information improves our understanding not only of how human activities affect environmental and ecological health, but also of how the quality of our environment and wildlife in turn affects human health. USGS is taking a leadership role in providing the natural science information needed by health researchers, policy makers, and the public to safeguard publichealth

In this article, we compared the characteristics of public and private accredited publichealth training programs. We analyzed the distinct opportunities and challenges that publicly funded schools of publichealth face in preparing the nation's publichealth workforce. Using our experience in creating a new, collaborative public school of publichealth in the nation's largest urban public university system, we described efforts to use our public status and mission to develop new approaches to educating a workforce that meets the health needs of our region and contributes to the goal of reducing health inequalities. Finally, we considered policies that could protect and strengthen the distinct contributions that public schools of publichealth make to improving population health and reducing health inequalities.

Digital government is typically defined as the production and delivery of information and services inside government and between government and the public using a range of information and communication technologies. Two types of government relationships with other entities are government-to-citizen and government-to-government relationships. Both offer opportunities and challenges. Assessment of a publichealth agency's readiness for digital government includes examination of technical, managerial, and political capabilities. Publichealth agencies are especially challenged by a lack of funding for technical infrastructure and expertise, by privacy and security issues, and by lack of Internet access for low-income and marginalized populations. Publichealth agencies understand the difficulties of working across agencies and levels of government, but the development of new, integrated e-programs will require more than technical change - it will require a profound change in paradigm.

Targeted marketing techniques, which identify consumers who share common needs or characteristics and position products or services to appeal to and reach these consumers, are now the core of all marketing and facilitate its effectiveness. However, targeted marketing, particularly of products with proven or potential adverse effects (e.g., tobacco, alcohol, entertainment violence, or unhealthful foods) to consumer segments defined as vulnerable raises complex concerns for publichealth. It is critical that practitioners, academics, and policy makers in marketing, publichealth, and other fields recognize and understand targeted marketing as a specific contextual influence on the health of children and adolescents and, for different reasons, ethnic minority populations and other populations who may benefit from publichealth protections. For beneficial products, such understanding can foster more socially productive targeting. For potentially harmful products, understanding the nature and scope of targeted marketing influences will support identification and implementation of corrective policies.

The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a publichealth issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders.

Community engagement in publichealth policy is easier said than done. One reason is that publichealth policy is produced in a complex process resulting in policies that may appear not to link up to citizen perspectives. We therefore address the central question as to whether citizen engagement in knowledge production could enable inclusive health policy making. Building on non-health work fields, we describe different types of citizen engagement in scientific research, or 'Citizen Science'. We describe the challenges that Citizen Science poses for publichealth, and how these could be addressed. Despite these challenges, we expect that Citizen Science or similar approaches such as participatory action research and 'popular epidemiology' may yield better knowledge, empowered communities, and improved community health. We provide a draft framework to enable evaluation of Citizen Science in practice, consisting of a descriptive typology of different kinds of Citizen Science and a causal framework that shows how Citizen Science in publichealth might benefit both the knowledge produced as well as the 'Citizen Scientists' as active participants.

Over half of the adults in Hawai‘i are overweight or obese, exposing them to increased risk for chronic diseases and resulting in higher health care expenses. Poor dietary habits and physical inactivity are important contributors to obesity and overweight. Because adults spend most of their waking hours at work, the workplace is an important setting for interventions to solve this growing problem. Changing the nutrition environment to support healthy eating is a recommended practice for worksite wellness interventions. Following this recommendation, the Hawai‘i State Department of Health (DOH) launched the Choose Healthy Now! Healthy Vending Pilot Project to increase access to healthy options in worksites. Choose Healthy Now! utilized an education campaign and a traffic light nutrition coding system (green = go, yellow = slow, red = uh-oh), based on federal nutrition guidelines, to help employees identify the healthier options in their worksite snack shops. Inventory of healthy items was increased and product placement techniques were used to help make the healthy choice the easy choice. DOH partnered with the Department of Human Services' Ho‘opono Vending Program to pilot the project in six government buildings on O‘ahu between May and September of 2014. Vendors added new green (healthy) and yellow (intermediate) options to their snack shop and cafeteria inventories, and labeled their snacks and beverages with green and yellow point-of-decision stickers. The following article outlines background and preliminary findings from the Choose Healthy Now! pilot. PMID:25414808

The development of primary care trusts requires health authority publichealth departments to work in new ways. Reviews of the publichealth function in two counties found widely varying views. A common understanding of organisations' responsibilities is crucial when developing publichealth in primary care. Publichealth networks can play a key role. Significant investment in training is required.

The Eastern Region PublicHealth Observatory (ERPHO) became part of PublicHealth England on April 1 2013. Its website provides population health data, analysis and interpretation to support healthcare professionals in commissioning, prioritising and improving health outcomes.

This paper highlights some of the challenges facing maternal health in Nepal and to suggest possible solutions for improvements. Key literature from across the globe is reviewed and discussed in a Nepalese context. Maternal mortality remains one of the biggest publichealth problems in Nepal. Lack of access to basic maternal healthcare, difficult geographical terrain, poorly developed transportation and communication systems, poverty, illiteracy, women's low status in the society, political conflict, shortage of health care professional and under utilization of currently available services are major challenges to improving maternal health in Nepal. In order to effect real improvements in maternal health, attention needs to be focused both on biomedical and social interventions. Improving health facilities, mother's nutrition, women's position in the society such as freedom of movement, providing education to female children, integrating Traditional Birth Attendants into local health services can play a vital role in the improvement of mothers' health.

Abstract In 2011, a small pilot bike share program was established in the town core of Kailua, Hawai‘i, with funding from the Hawai‘i State Department of Health. The Kailua system consisted of two stations with 12 bicycles, and the goal was to secure additional funding to expand the station network in the future. Community feedback consistently indicated support for the bike share program. However, system metrics showed low levels of usage, averaging 41.5 rides per month (2011–2014). From observational data, users were primarily tourists. With minimal local staff, the bike share program had limited resources for promotion and education, which may have hindered potential use by local residents. Management of station operations and bike maintenance were additional, ongoing barriers to success. Despite the challenges, the pilot bike share program was valuable in several ways. It introduced the bike share concept to Hawai‘i, thereby helping to build awareness and connect an initial network of stakeholders. Furthermore, the pilot bike share program informed the development of a larger bike share program for urban Honolulu. As limited information exists in the literature about the experiences of smaller bike share programs and their unique considerations, this article shares lessons learned for other communities interested in starting similar bike share programs. PMID:26535166

The absence of appropriate financial management competencies has impeded progress in advancing the field of publichealth finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within publichealth and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of publichealth financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs.

Many calls have been made for a systems approach to publichealth. My response is to offer a methodology for systemic intervention that (1) emphasizes the need to explore stakeholder values and boundaries for analysis, (2) challenges marginalization, and (3) draws upon a wide range of methods (from the systems literature and beyond) to create a flexible and responsive systems practice. I present and discuss several well-tested methods with a view to identifying their potential for supporting systemic intervention for publichealth. PMID:16449577

The globalization of publichealth poses new threats to health but also holds important opportunities in the coming century. This commentary identifies the major threats and opportunities presented by the process of globalization and emphasizes the need for transnational publichealth approaches to take advantage of the positive aspects of global change and to minimize the negative ones. Transnational publichealth issues are areas of mutual concern for the foreign policies of all countries. These trends indicate a need for cross-national comparisons (e.g., in the areas of health financing and policy development) and for the development of a transnational research agenda in publichealth. PMID:9585736

The Association of Schools of PublicHealth (ASPH) has developed a comprehensive set of core academic competencies for master of publichealth (MPH) graduates. The ASPH core MPH competencies delineate fundamental knowledge, attitudes, and skills that every MPH student, regardless of their major field, should possess upon graduation. From a publichealth agency perspective, this is a promising development. The ASPH MPH core competencies are complementary to the Core Competencies for PublicHealth Practice developed by the Council on Linkages Between Academia and PublicHealth Practice. Although a useful development, the academic MPH core competencies should not be confused with a conclusive definition of what constitutes a publichealth professional.

Environmental exposures cause substantial morbidity and mortality in the United States. A major goal of Centers for Disease Control and Prevention Environmental PublicHealth Tracking program is the development of a national network of health and environmental data with analytic tools for rapid evaluation of specific national or regional environmental health concerns. A six-state collaborative project in the northeast United States was established to assess the feasibility of such a system, assessing the possible association between ambient air quality and adverse birth outcomes. For this regional surveillance project, issues were discussed surrounding the design of a mutually acceptable protocol, obtaining human subjects' protection approvals, obtaining and organizing both the exposure and outcome data, analyzing the data both locally and regionally, and planning subsequent interventions to address identified publichealth concerns.

EPA’s Community PublicHealth (CPH) project in the Office of Research and Development (ORD) produces high quality science and tools to understand and assess environmental risks and ecosystem goods and services (EGS) to decision-makers at all levels.

INTRODUCTION Trauma is the fifth principal cause of death in Singapore, with traumatic brain injury (TBI) being the leading specific subordinate cause. METHODS This study was an eight-year retrospective review of the demographic profiles of patients with severe TBI who were admitted to the neurointensive care unit (NICU) of the National Neuroscience Institute at Tan Tock Seng Hospital, Singapore, between 2004 and 2011. RESULTS A total of 780 TBI patients were admitted during the study period; 365 (46.8%) patients sustained severe TBI (i.e. Glasgow Coma Scale score ≤ 8), with the majority (75.3%) being male. The ages of patients with severe TBI ranged from 14–93 years, with a bimodal preponderance in young adults (i.e. 21–40 years) and elderly persons (i.e. > 60 years). Motor vehicle accidents (48.8%) and falls (42.5%) were the main mechanisms of injury. Invasive line monitoring was frequently employed; invasive arterial blood pressure monitoring and central venous pressure monitoring were used in 81.6% and 60.0% of the patients, respectively, while intracranial pressure (ICP) measurement was required in 47.4% of the patients. The use of tiered therapy to control ICP (e.g. sedation, osmotherapy, cerebrospinal fluid drainage, moderate hyperventilation and barbiturate-induced coma) converged with international practices. CONCLUSION The high-risk groups for severe TBI were young adults and elderly persons involved in motor vehicle accidents and falls, respectively. In the NICU, the care of patients with severe TBI requires heavy utilisation of resources. The healthcare burden of these patients extends beyond the acute critical care phase. PMID:26768061

The development of the British publichealth services is briefly reviewed and it is suggested that two types of epidemiologist (Community Physician) are necessary in each locality: one concerned with medical administration and health care planning-the medical administrator, and the other with the prevention of disease-the clinical epidemiologist. A new nation publichealth service is proposed to revive disease prevention with four main features: (1) A district Clinical Epidemiologist who is a member of the district department of community medicine with responsibility for prevention but with no district administrative duties. (2) A District Epidemiology Unit comprising other appropriate staff. (3) National specialist epidemiology units within the NHS with service roles to support and coordinate the District Clinical Epidemiologists. (4) A national authority within the NHS with responsibility for prevention and for administering the national specialist units. PMID:7007637

Self-organized criticality offers more than a descriptive model or a doomsday forecast. We have tried to suggest that it is a paradigm for understanding the interconnections between apparently complex processes. At best, it suggests a method for finding the pressure points that can be used to bring unstable systems of publichealth services into greater levels of stability. The model enjoins us to understand that our goal is not to achieve equilibrium--that perfect match between the demand for health services and its delivery--but rather stability (or, more precisely, metastability). As is true of the sandpile, our systems of publichealth are constantly evolving. If we are correct, then the mechanism driving this ostensibly complex pattern of change and growth reflects the existence of simpler and, hopefully, more manageable processes. By monitoring these processes, it may be increasingly possible to adapt to change and even manage it effectively. PMID:9170831

Publichealth nutrition is focused on the prevention of diet-related diseases and the attainment of good health, through policy, education and health promotion. It involves many sectors of the community, cooperating to improve the health and wellbeing of the population with emphasis on prevention, equity, wellbeing and improved quality of life. In the majority of western countries, an epidemic of coronary heart disease (CHD) began after World War One, reaching its peak in the 1970's. In Asia, the epidemic began after WW2 with the rapid economic development of the region. In western countries, of which Australia is a typical example, health promotion activities and improved hospital treatment have been effective in reducing the impact of the CHD epidemic. The life expectancy of the population has steadily grown to 75.6 years for males and 81.3 years for females. Despite major advances in the prevention and treatment of cardiovascular disease, it is still the leading cause of premature mortality and morbidity in Australia. Furthermore, cardiovascular disease shares common risk factors with other leading causes of death, including lifestyle behaviours (diet, physical inactivity, alcohol consumption, smoking), physiological states (obesity, hypertension, high blood cholesterol) and socioeconomic factors. For Asia, the challenge is to implement publichealth policies that will tackle the epidemic of chronic disease before it reaches its peak. Health Promotion policies will be important for all countries. The use of the disability adjusted life years (DALY) methodology to measure the association between the cause of disease and relate its occurrence to health outcomes will be an important publichealth planning tool.

Few studies have been made of the impact of major construction on the health of nearby residents. We conducted a feasibility study in one zip code (02111; Chinatown, Boston, MA, USA) in which four large buildings (20-30 stories) were built between 1999 and 2004 and adjacent to which a major highway construction project was in progress. Information about major construction project start and end dates were obtained from a variety of sources. Three sets of health data--emergency department and mortality-were obtained from the Massachusetts Department of PublicHealth for the years of 1998 - 2004. We used ICD-9 and ICD-10 disease codes to aggregate selected pulmonary and cardiac-related categories that could reasonably be expected to be aggravated by air pollution released from construction sites, including diesel and dust, and noise and vibration. We propose that larger-scale studies are possible and needed using approaches similar to ours.

Publichealth law is an emerging field in U.S. publichealth practice. The 20th century proved the indispensability of law to publichealth, as demonstrated by the contribution of law to each of the century's 10 great publichealth achievements. Former CDC Director Dr. William Foege has suggested that law, along with epidemiology, is an essential tool in publichealth practice. Publichealth laws are any laws that have important consequences for the health of defined populations. They derive from federal and state constitutions; statutes, and other legislative enactments; agency rules and regulations; judicial rulings and case law; and policies of public bodies. Government agencies that apply publichealth laws include agencies officially designated as "publichealth agencies," as well as health-care, environmental protection, education, and law enforcement agencies, among others.

During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the publichealth sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a publichealth perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a publichealth framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the majorpublichealth issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater publichealth involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via publichealth inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of publichealth surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant's likelihood of health code violation measured by the assigned San Francisco publichealth code rating. For a list of majorhealth code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74% sensitivity

Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via publichealth inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of publichealth surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant’s likelihood of health code violation measured by the assigned San Francisco publichealth code rating. For a list of majorhealth code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74

In District of Columbia v. Heller, the U.S. Supreme Court ruled that the Second Amendment protects an individual's right to own handguns in the home for protection, invalidating a Washington, D.C. law banning most handgun possession. The Heller decision, however, provided lower courts with little guidance regarding how to judge the constitutionality of gun laws other than handgun bans. Nevertheless, lower courts have upheld the vast majority of federal, state, and local gun laws challenged since Heller. One area in which some lower courts have disagreed has been the constitutionality of laws regulating the ability to carry firearms in public. This issue may be the next to be addressed by the Supreme Court under its evolving Second Amendment jurisprudence. Courts should carefully consider the negative publichealth and safety implications of gun carrying in public as they weigh the constitutionality of these laws.

Social marketing uses the principles and techniques of commercial marketing by applying them to the complex social context in order to promote changes (cognitive; of action; behavioral; of values) among the target population in the public interest. The advent of Internet has radically modified the communication process, and this transformation also involved medical-scientific communication. Medical journals, health organizations, scientific societies and patient groups are increasing the use of the web and of many social networks (Twitter, Facebook, Google, YouTube) as channels to release scientific information to doctors and patients quickly. In recent years, even Healthcare in Italy reported a considerable application of the methods and techniques of social marketing, above all for health prevention and promotion. Recently the association for health promotion "Social marketing and health communication" has been established to promote an active dialogue between professionals of social marketing and publichealth communication, as well as among professionals in the field of communication of the companies involved in the "health sector". In the field of prevention and health promotion it is necessary to underline the theme of the growing distrust in vaccination practices. Despite the irrefutable evidence of the efficacy and safety of vaccines, the social-cultural transformation together with the overcoming of compulsory vaccination and the use of noninstitutional information sources, have generated confusion among citizens that tend to perceive compulsory vaccinations as needed and safe, whereas recommended vaccinations as less important. Moreover, citizens scarcely perceive the risk of disease related to the effectiveness of vaccines. Implementing communication strategies, argumentative and persuasive, borrowed from social marketing, also for the promotion of vaccines is a priority of the health system. A typical example of the application of social marketing, as

Background The efficacy of antidepressant medication has been shown empirically to be overestimated due to publication bias, but this has only been inferred statistically with regard to psychological treatment for depression. We assessed directly the extent of study publication bias in trials examining the efficacy of psychological treatment for depression. Methods and Findings We identified US National Institutes of Health grants awarded to fund randomized clinical trials comparing psychological treatment to control conditions or other treatments in patients diagnosed with major depressive disorder for the period 1972–2008, and we determined whether those grants led to publications. For studies that were not published, data were requested from investigators and included in the meta-analyses. Thirteen (23.6%) of the 55 funded grants that began trials did not result in publications, and two others never started. Among comparisons to control conditions, adding unpublished studies (Hedges’ g = 0.20; CI95% -0.11~0.51; k = 6) to published studies (g = 0.52; 0.37~0.68; k = 20) reduced the psychotherapy effect size point estimate (g = 0.39; 0.08~0.70) by 25%. Moreover, these findings may overestimate the "true" effect of psychological treatment for depression as outcome reporting bias could not be examined quantitatively. Conclusion The efficacy of psychological interventions for depression has been overestimated in the published literature, just as it has been for pharmacotherapy. Both are efficacious but not to the extent that the published literature would suggest. Funding agencies and journals should archive both original protocols and raw data from treatment trials to allow the detection and correction of outcome reporting bias. Clinicians, guidelines developers, and decision makers should be aware that the published literature overestimates the effects of the predominant treatments for depression. PMID:26422604

This article outlines and discusses five categories of information about individual jails that should be considered before making general statements about jails. These are (a) the process by which individuals come to and are processed through the jail, (b) the size of the jail, (c) the region of the country where the jail is situated, (d) classification/assessment techniques, and (e) architecture and supervision styles. It is hoped that this discussion will generate a better understanding of the complexity of jail systems across the nation and help publichealth professionals better target their research, programs, and policies directed at the jail/community health nexus.

Skill in marketing is a scarce resource in publichealth, especially in developing countries. The Global Public–Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for publichealth, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships. PMID:17329646

A special Committee on Internal Medicine and PublicHealth was established by Sociedad Médica de Santiago (Chilean Society of Internal Medicine) in April 2007 with the duty to write a Consensus Paper on the interaction between both branches of medical profession. The main objective was to find the common grounds on which to construct a positive approach to regain space for Internal Medicine, based on prevalent epidemiológical features related to adult health issues. The authors describe the reasons to explain the gap between clinical medicine and population health and identify the nature and evolution of chronic diseases as the point of encounter between both. With Chilean health surveys data, they state that chronic diseases explain the high proportion of burden of disease, mortality and disability, and stress that by the year 2025 one in every five inhabitants will be over 65 years of age, with ageing as another main problem for the health care sector. Population with multiple risks and multimorbidity is the most important challenge for the Chilean Health Care System. A new model of care is needed to tackle this scenario with new skills regarding psychosocial determinants of health. The leading role of internists and ideally geriatricians, will be crucial in this process and will help the implementation of sound population based interventions. Both individual and community level interventions will help to improve quality of life of Chilean families.

The purpose of the study in this article was to identify The needs of publichealth managers with regard to publichealth finance. A survey of publichealth practitioners regarding competencies was conducted and a review of course offerings in finance among schools of publichealth was performed. Most publichealth practitioners surveyed believe that a broad array of management competencies are required to administer the finances of a publichealth facility or department. Respondents added 35 competencies to those initially given to them for review. Most added competencies that were more specific than the original competencies or could be viewed as subpoints of the original competencies. Many schools offered no courses specifically addressing publichealth care finance, with a few offering at most only one publichealth finance course. All schools offered at least one corporate finance course, and the majority offered two or more courses. We conclude with a number of recommendations for education and competency development, suggesting several next steps that can advance the field of publichealth's understanding of what managers need to master in publichealth finance to effectively function as publichealth managers.

Causal inference has a central role in publichealth; the determination that an association is causal indicates the possibility for intervention. We review and comment on the long-used guidelines for interpreting evidence as supporting a causal association and contrast them with the potential outcomes framework that encourages thinking in terms of causes that are interventions. We argue that in publichealth this framework is more suitable, providing an estimate of an action’s consequences rather than the less precise notion of a risk factor’s causal effect. A variety of modern statistical methods adopt this approach. When an intervention cannot be specified, causal relations can still exist, but how to intervene to change the outcome will be unclear. In application, the often-complex structure of causal processes needs to be acknowledged and appropriate data collected to study them. These newer approaches need to be brought to bear on the increasingly complex publichealth challenges of our globalized world. PMID:23297653

Efforts to develop the publichealth workforce since 2001 have benefited from increased funding resulting from concerns over terrorism and other publichealth threats. This largesse has been accompanied by the need for greater accountability for results. The size, composition, and distribution of the publichealth workforce have long been policy concerns. Production and retention of publichealth workers remain important issues, although new dimensions of readiness are also taking center stage. We offer here policy recommendations in the areas of assessing the publichealth workforce and its needs, organizing development efforts around essential competencies for publichealth practice, credentialing workers, and accrediting agencies.

INTRODUCTION Monitoring and modifying physicians’ prescribing behavior through prescription tracking is integral to pharmaceutical marketing. Health information organizations (HIOs) combine prescription information purchased from pharmacies with anonymized patient medical records purchased from health insurance companies to determine which drugs individual physicians prefer for specific diagnoses and patient populations. This information is used to tailor marketing strategies to individual physicians and to assess the effect of promotions on prescribing behavior. DISCUSSION The American Medical Association (AMA) created the Prescription Data Restriction Plan in an attempt to address both the privacy concerns of physicians and industry concerns that legislation could compromise the availability of prescribing data. However, the PDRP only prohibits sales representatives and their immediate supervisors from accessing the most detailed reports. Less than 2% of US physicians have registered for the PDRP, and those who have signed up are not the physicians who are targeted for marketing. CONCLUSION Although it has been argued that prescription tracking benefits publichealth, data gathered by HIOs is designed for marketing drugs. These data are sequestered by industry and are not generally available for genuine publichealth purposes. PMID:18473146

A review of the literature is provided for the topic of health-related research and power frequency electromagnetic fields. Minimal evidence for concern is present on the basis of animal and plant research. General observation would accord with the implication that there is no single and manifest health effect as the result of exposure to these fields. There are persistent indications, however, that these fields have biologic activity, and consequently, there may be a deleterious component to their action, possibly in the presence of other factors. Power frequency electromagnetic field exposures are essentially ubiquitous in modern society, and their implications in the larger perspective of publichealth are unclear at this time. Electromagnetic fields represent a methodological obstacle for epidemiologic studies and a quandary for risk assessment; there is need for more data. PMID:3319560

The goal has been set to establish NASA as number one in safety in the nation. This includes Systems and Mission Safety as well as Occupational Safety for all NASA employees and contractors on and off the job. There are five majorhealth and safety issues important in the pursuit of being number one and they are: (1) Radiation (2) Hearing (3) Habitability/Toxicology (4) Extravehicular Activity (EVA) (5) Stress. The issues have features of accumulated injury since NASA's future missions involve long time human presence in space i.e., International Space Station operations and Mars missions. The objective of this paper is to discuss these five issues in terms of controlling risks and enhancing health and safety. Safety metrics are discussed in terms of the overall goal of NASA to be number one in safety. .

Obesity is associated with chronic diseases that may negatively affect individuals’ health and the sustainability of the health care system. Despite increasing emphasis on obesity as a majorhealth care issue, little progress has been made in its treatment or prevention. Individual approaches to obesity treatment, largely composed of weight-loss dieting, have not proven effective. Little direct evidence supports the notion of reforms to the “obesogenic environment.” Both these individualistic and environmental approaches to obesity have important limitations and ethical implications. The low levels of success associated with these approaches may necessitate a new non–weight-centric publichealth strategy. Evidence is accumulating that a weight-neutral, nutrition- and physical activity–based, Health at Every Size (HAES) approach may be a promising chronic disease-prevention strategy. PMID:24328657

Social medicine, publichealth and governance for health have a long tradition in the Czech Republic but some problems persist. Possible solutions are reliable information, research, education and training. Action plans for Health 2020 implementation are appreciated as well as a valuable help of the WHO Country Office, Czech Republic.Key words: social medicine, publichealth, health, health governance, governance for health, Health 2020, World Health Organization.

Although interest in the field of publichealth law has dramatically increased over the past two decades, there remain significant challenges in communicating and sharing publichealth law-related knowledge. Access to quality information, which may assist in a publichealth department's efforts to protect the public's health, welfare, and safety, varies widely from jurisdiction to jurisdiction, and interjurisdictional communication remains at best a patchwork quilt with many holes. What follows is an analysis of several approaches the PublicHealth Law Association or other publichealth law-related organizations might undertake to serve as a conduit for the identification, gathering, and dissemination of extant publichealth law information, as well as the development of new publichealth law-related content, with a particular focus on the use of electronic means for such efforts.

Issues arising in connection with genes and nutrition policy include both nutrigenomics and nutrigenetics. Nutrigenomics considers the relationship between specifc nutrients or diet and gene expression and, it is envisaged, will facilitate prevention of diet-related common diseases. Nutrigenetics is concerned with the effects of individual genetic variation (single nucleotide polymorphisms) on response to diet, and in the longer term may lead to personalised dietary recommendations. It is important also to consider the surrounding context of other issues such as novel and functional foods in so far as they are related to genetic modification. Ethical issues fall into a number of categories: (1) why nutrigenomics? Will it have important publichealth benefits? (2) questions about research, e.g. concerning the acquisition of information about individual genetic variation; (3) questions about who has access to this information, and its possible misuse; (4) the applications of this information in terms of publichealth policy, and the negotiation of the potential tension between the interests of the individual in relation to, for example, prevention of conditions such as obesity and allergy; (5) the appropriate ethical approach to the issues, e.g. the moral difference, if any, between therapy and enhancement in relation to individualised diets; whether the 'technological fix' is always appropriate, especially in the wider context of the purported lack of public confidence in science, which has special resonance in the sphere of nutrition.

The legend about Parmentier is quite reductive when it limits his activity to the promotion of potato. This military pharmacist intended mainly to make science serve human being, whatever could be his various activities. Actor of the foundation of food chemistry, reorganizer of military pharmacy, he has always been highly concerned with hygiene and publichealth. He then studied the quality of water, particularly in the case of river Seine, or the purity of air, especially in hospitals. The affair of Dunkerque exhumations or that of cesspools, or the utilisation of human excrements in agriculture were parts of the occurrences for which he had the opportunity to find a scientific approach allowing to solve the difficult questions that were asked to him, for the best benefit of publichealth. The exhaustive study he published in "Bulletin de pharmacie" for the conservation of meat shows that he did not ignore anything about freezing of food in order to preserve it. It is necessary not to forget the important role he played, as soon as he were informed of Jenner's discovery, for the diffusion of vaccination in France. It is simply astounding to observe how modern were the questions he solved and how intense was his spirit of dedication to the public good, when exerting his functions in "Comité de Salubrité de la Seine" or "Conseil de Santé des Armées", as well as outside these prestigious institutions.

Changing threats to the public's health necessitate a profound transformation of the publichealth enterprise. Despite recent attention to the biodefense role of publichealth, policymakers have not developed a clear, realistic vision for the structure and functionality of the governmental publichealth system. Lack of leadership and organizational disconnects across levels of government have prevented strategic alignment of resources and undermined momentum for meaningful change. A transformed publichealth system is needed to address the demands of emergency preparedness and health protection. Such transformation should include focused, risk-based resource allocation; regional planning; technological upgrades; workforce restructuring; improved integration of private-sector assets; and better performance monitoring.

Publichealth ethics is emerging as a new field of inquiry, distinct not only from publichealth law, but also from traditional medical ethics and research ethics. Publichealth professional and scholarly attention is focusing on ways that ethical analysis and a new publichealth code of ethics can be a resource for health professionals working in the field. This article provides a preliminary exploration of the ethical issues faced by publichealth professionals in day-to-day practice and of the type of ethics education and support they believe may be helpful.

Massive open online courses (MOOCs) represent a new and potentially transformative model for providing educational opportunities to learners not enrolled in a formal educational program. The authors describe the experience of developing and offering eight MOOCs on a variety of publichealth topics. Existing institutional infrastructure and experience with both for-credit online education and open educational resources mitigated the institutional risk and resource requirements. Although learners are able to enroll easily and freely and do so in large numbers, there is considerable variety in the level of participation and engagement among enrollees. As a result, comprehensive and accurate assessment of meaningful learning progress remains a major challenge for evaluating the effectiveness of MOOCs for providing publichealth education. PMID:24350228

For the first time in recent history, a majority of the schoolchildren attending the nation's public schools come from low income families. The latest data collected from the states by the National Center for Education Statistics (NCES), evidence that 51 percent of the students across the nation's public schools were low income in 2013. The…

In Italy, the year 1946 was characterized, on one hand, by the growing concern for the lack of public structures and, on the other, by the hopes placed in the research sector, namely the apparently inexhaustible properties of penicillin and antibiotics. Consistently, Igiene e Sanità Pubblica reflected the general mood of the hygienists, swinging between the strong protests against a far too slow political system incapable of spurring scientific research, and the constant engagement aimed at enhancing the future role of publichealth. Besides facing many institutional problems, such as claiming an official recognition for their profession, hygienists also managed to make Italians understand the real value of a discipline conceived for the community service.

School nurses (SNs) use publichealth nursing knowledge and skills to provide nursing services to school populations. The PublicHealth Intervention Wheel is a practice framework that can be used to explain and guide publichealth nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

Background: Looking at the current scenario of shortage of publichealth professionals on one hand and intense demand of community health services on the other it is imperative that the contribution of Ayurveda practitioners is increased in the field of publichealth. However, the updating of the knowledge of publichealth issues and concepts will ultimately decide whether they can be successfully integrated into the community health arena or not. Aim: This study was conducted to assess the knowledge level of Ayurveda practitioners about publichealth Issues with the aim find out the competence of Ayurveda practitioners regarding knowledge of publichealth issues. Materials and Methods: Cross-sectional study was conducted in the union territory, Chandigarh and two districts each of the states of Haryana and Punjab. Publichealth knowledge assessment tool comprising a questionnaire was used to collect information from the respondents who were registered Ayurveda doctors and interns. The data was analyzed with the help of IBM SPSS (Statistical Product and Service Solutions). Results: The respondents scored between 5 and 17 points out of a total of 19 points and majority (82%) of the respondents fell in the category of “having average knowledge”. The mean score was 8.42 ± 2. Conclusion: Curriculum and training of Ayurveda education need to have more publichealth related inputs and hence that the Ayurveda practitioners are well-versed with the publichealth concepts and could contribute in the publichealth field meaningfully. PMID:25364193

Publichealth surveillance conducted by health departments in the United States has improved in completeness and timeliness owing to electronic laboratory reporting. However, the collection of detailed clinical information about reported cases, which is necessary to confirm the diagnosis, to understand transmission, or to determine disease-related risk factors, is still heavily dependent on manual processes. The increasing prevalence and functionality of electronic health record (EHR) systems in the United States present important opportunities to advance publichealth surveillance. EHR data have the potential to further increase the breadth, detail, timeliness, and completeness of publichealth surveillance and thereby provide better data to guide publichealth interventions. EHRs also provide a unique opportunity to expand the role and vision of current surveillance efforts and to help bridge the gap between publichealth practice and clinical medicine.

The 1992 edition of the Financial Statistics of Major US Publicly Owned Electric Utilities publication presents 4 years (1989 through 1992) of summary financial data and current year detailed financial data on the majorpublicly owned electric utilities. The objective of the publication is to provide Federal and State governments, industry, and the general public with current and historical data that can be used for policymaking and decisionmaking purposes related to publicly owned electric utility issues. Generator and nongenerator summaries are presented in this publication. Four years of summary financial data are provided. Summaries of generators for fiscal years ending June 30 and December 31, nongenerators for fiscal years ending June 30 and December 31, and summaries of all respondents are provided. The composite tables present aggregates of income statement and balance sheet data, as well as financial indicators. Composite tables also display electric operation and maintenance expenses, electric utility plant, number of consumers, sales of electricity, and operating revenue, and electric energy account data. The primary source of publicly owned financial data is the Form EIA-412, {open_quotes}Annual Report of Public Electric Utilities.{close_quotes} Public electric utilities file this survey on a fiscal year, rather than a calendar year basis, in conformance with their recordkeeping practices. In previous editions of this publication, data were aggregated by the two most commonly reported fiscal years, June 30 and December 31. This omitted approximately 20 percent of the respondents who operate on fiscal years ending in other months. Accordingly, the EIA undertook a review of the Form EIA-412 submissions to determine if alternative classifications of publicly owned electric utilities would permit the inclusion of all respondents.

Clinical and publichealth research data have shown that a number of individual, professional and community health measures may be valuable in preventing the major oral diseases. The fundamental gap in knowledge, however, is not confined to 'what to do' but rather 'how' to translate the scientific findings into effective and sustainable programs for groups and populations. The advances in oral health science have not yet benefitted the poor and disadvantaged population groups around the world to the fullest extent possible and this has led to inequalities in periodontal health as well as in other chronic diseases. Research on the causative role of tobacco use in periodontal disease is strong because of the fact that tobacco-induced disease ultimately may lead to the loss of teeth. Studies also indicate that wound healing may be negatively affected by the use of tobacco. Likewise, research has shown that extreme use of alcohol, poor diet and nutrition, and psychological stress all have negative effects on periodontal health. Research on sociobehavioral risk factors has great implication to prevent periodontal disease. The case for tobacco is illustrated in this report. The global exposure to tobacco use in adults and adolescents is outlined. Because of the global Framework Convention for Tobacco Control (2003), the solid research on the harmful effect of tobacco is now being widely used for publichealth. The importance of tobacco prevention within the context of health-promoting schools is emphasized. Research on other population-directed strategies and their implications on publichealth would be instrumental to integrated prevention of chronic disease and periodontal disease. Community interventions and delivery of preventive oral care by oral health services may have positive outcomes for periodontal health but periodontal research needs to be further strengthened by the provision of sound evidence. It is somewhat remarkable that research on true population

The AMIA 2001 Spring Congress brought together members of the the publichealth and informatics communities to develop a national agenda for publichealth informatics. Discussions of funding and governance; architecture and infrastructure; standards and vocabulary; research, evaluation, and best practices; privacy, confidentiality, and security; and training and workforce resulted in 74 recommendations with two key themes—that all stakeholders need to be engaged in coordinated activities related to publichealth information architecture, standards, confidentiality, best practices, and research; and that informatics training is needed throughout the publichealth workforce. Implementation of this consensus agenda will help promote progress in the application of information technology to improve publichealth. PMID:11687561

It is a well-known fact that nursing and feminism have enjoyed an uneasy alliance. In recent years, however, nursing has begun to recognize the importance of feminism. Nevertheless, the literature still rarely addresses the relevance of feminism for publichealth nursing. In this article, I articulate the relevance of feminism for publichealth nursing knowledge and practice. First, I define and describe feminism and publichealth nursing and then I discuss the importance of feminism for publichealth nursing practice. The importance of feminism for the metaparadigm concepts of publichealth nursing is then reviewed. Finally, I examine several existing challenges relating to feminism and publichealth nursing research, education, and practice. The thesis of this article is that feminism is vitally important for the development of publichealth nursing and for publichealth care.

Knowledge plays an important role in health care. The production and diffusion of health-related knowledge are increasingly under the control of private commercial interests, which are characterized by conflicts of interests that result in abuses of power. Considerable research has been done on the medical-industrial complex and its role in the production of power imbalances and the consequent abuses, but little attention has been dedicated to the role played by the publishing industry, which can be subject to the same problems. The widely diffused idea that 'frequent and major changes' occur in medicine, albeit unsupported by clearcut evidence, is an effective marketing tool for both the pharmaceutical and publishing industries, who feed and thrive on physicians' insecurities. The production and distribution of knowledge should be addressed as a strategic component of publichealth.

Schools of PublicHealth cannot sustain the national momentum for publichealth justice and human rights without recruiting and training a skilled publichealth workforce. With growing demand for publichealth workers, schools must work to increase their applicant pools. This project examined prospect communication materials from accredited Schools of PublicHealth and found that the vast majority of schools did not capitalize on opportunities to move prospects to applicants. Whereas most responded within a reasonable time, several schools made no communication efforts at all. Recruitment materials varied widely from institution to institution and between epidemiology and health education programs. Strategic, personalized communication strategies-the 3 Cs-are recommended to increase the pools of qualified applicants nationwide and can be utilized to increase prospect pools in a wide range of health sciences.

Joint efforts by fields of publichealth in the last decade have advocated use of the built environment to protect health. Past involvement by publichealth advocates in urban policy, however, has had mixed results. Although publichealth has significantly contributed to health improvements, its participation in urban renewal activities was problematic. Health advocates and the American PublicHealth Association produced guidelines that were widely used to declare inner-city areas blighted and provided a scientific justification for demolishing neighborhoods and displacing mostly poor and minority people. Furthermore, health departments failed to uphold their legal responsibility to ensure that relocated families received safe, affordable housing alternatives. These failures have important implications for future health-related work on the built environment and other core publichealth activities. PMID:19608955

Joint efforts by fields of publichealth in the last decade have advocated use of the built environment to protect health. Past involvement by publichealth advocates in urban policy, however, has had mixed results. Although publichealth has significantly contributed to health improvements, its participation in urban renewal activities was problematic. Health advocates and the American PublicHealth Association produced guidelines that were widely used to declare inner-city areas blighted and provided a scientific justification for demolishing neighborhoods and displacing mostly poor and minority people. Furthermore, health departments failed to uphold their legal responsibility to ensure that relocated families received safe, affordable housing alternatives. These failures have important implications for future health-related work on the built environment and other core publichealth activities.

We investigated ways of defining and measuring the value of services provided by governmental publichealth systems. Our data sources included literature syntheses and qualitative interviews of publichealth professionals. Our examination of the health economic literature revealed growing attempts to measure value of publichealth services explicitly, but few studies have addressed systems or infrastructure. Interview responses demonstrated no consensus on metrics and no connection to the academic literature. Key challenges for practitioners include developing rigorous, data-driven methods and skilled staff; being politically willing to base allocation decisions on economic evaluation; and developing metrics to capture “intangibles” (e.g., social justice and reassurance value). Academic researchers evaluating the economics of publichealth investments should increase focus on the working needs of publichealth professionals. PMID:18923123

Reviews of publichealth emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in publichealth curricula. To develop criteria for crisis leadership in publichealth, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in publichealth. Based on this review, the following attributes are proposed for crisis leadership in publichealth: competence in publichealth science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in publichealth science is currently a goal of publichealth education. Strategies to teach the other proposed attributes of crisis leadership will better prepare publichealth leaders to meet the challenges of publichealth crises.

The judicial branch’s key roles, as guardian of civil liberties and protector of the rule of law, can be acutely relevant during publichealth emergencies when courts may need to issue orders authorizing actions to protect publichealth or restraining publichealth actions that are determined to unduly interfere with civil rights. Legal preparedness for publichealth emergencies, therefore, necessitates an understanding of the court system and how courts are involved in publichealth issues. In this article we briefly describe the court system and then focus on what publichealth practitioners need to know about the judicial system in a publichealth emergency, including the courts’ roles and the consequent need to keep courts open during emergencies. PMID:17413084

Climate change has been identified as a serious threat to human health, associated with the sustainability of current practices and lifestyles. Nurses should expand their health promotion role to address current and emerging threats to health from climate change and to address ecological publichealth. This article briefly outlines climate change and the concept of ecological publichealth, and discusses a 2012 review of the role of the nurse in health promotion.

New psychoactive substances (NPS) have completely modified the drug scene and the current landscape of addiction. Synthetic substances, such as substituted or synthetic cathinones, also known as « legal highs », are often produced and used to mimic the effects of controlled drugs such as cocaine, methylenedioxymethamphetamine (MDMA, ecstasy), and methamphetamine. The overwhelming majority of synthetic cathinones are produced in China and South East Asian countries. The Internet has emerged as the new marketplace for NPS, playing a major role in providing information on acquisition, synthesis, extraction, identification, and substance use. All these compounds are intentionally mislabeled and sold on-line under slang terms such as bath salts, plant food, plant feeders and research chemicals. They are sometimes labeled « not for human use » or « not tested for hazards or toxicity ». The rapid spread of NPS forces member countries of the European Union to adapt their response to the potential new dangers that may cause. To date, not only health actors but also the general public need to be clearly informed and aware of dangers resulting from NPS spread and use. Here, we review the major clinical effects of synthetic cathinones to highlight their impact on publichealth. A literature search was conducted from 2009 to 2014 based on PubMed, Google Scholar, Erowid, and governmental websites, using the following keywords alone or in combination: "new psychoactive substances", "synthetic cathinones", "substituted cathinones", "mephedrone", "methylone", "MDPV", "4-MEC", "addiction", and "substance use disorder".

This paper explores the relationship between public housing, health outcomes, and health behaviors among low-income housing residents. While public housing can be a dangerous and unhealthy environment in which to live, the subsidized rent may free up resources for nutritious food and health care. In addition, public housing may be of higher…

Diarrheal illnesses remain among the leading causes of morbidity in the United States. Approximately five million diarrheal cases occur annually (Chin, 2000; Ostroff & Leduc, 2000), with an estimated incidence of one diarrheal episode per person per year (Aranda-Michel & Giannella, 1999). Though the causes of diarrheal illnesses vary, infectious agents account for a majority of cases (Aranda-Michel & Giannella, 1999; Chin, 2000; Ostroff & Leduc, 2000). Most diarrhea-causing infectious agents are transmitted through food, water, or person-to-person via the fecal-oral route and are the cause of numerous diarrheal outbreaks. The risk for exposure to such pathogens within the general population is universal; however, persons in pediatric, geriatric, and other immunocompromised populations are at increased risk for subsequent illness and complications (Centers for Disease Control and Prevention, 2001; Ostroff & Leduc, 2000). Moreover, many persons with diarrheal illness do not seek medical care and self-treat with over-the-counter antidiarrheal agents, which have potentially serious side effects among high-risk individuals. The publichealth impact of diarrheal illness is apparent and emphasizes the need for early diagnosis and appropriate treatment, timely notification of illness with publichealth implications, and coordination between healthcare professionals and publichealth officials to prevent and control the spread of infection.

The 1996 edition of The Financial Statistics of Major US Publicly Owned Electric Utilities publication presents 5 years (1992 through 1996) of summary financial data and current year detailed financial data on the majorpublicly owned electric utilities. The objective of the publication is to provide Federal and State governments, industry, and the general public with current and historical data that can be used for policymaking and decision making purposes related to publicly owned electric utility issues. Generator and nongenerator summaries are presented in this publication. Five years of summary financial data are provided. Summaries of generators for fiscal years ending June 30 and December 31, nongenerators for fiscal years ending June 30 and December 31, and summaries of all respondents are provided. The composite tables present aggregates of income statement and balance sheet data, as well as financial indicators. Composite tables also display electric operation and maintenance expenses, electric utility plant, number of consumers, sales of electricity, and operating revenue, and electric energy account data. 2 figs., 32 tabs.

Twenty-three publichealth schools and 492 university schools of nursing were surveyed to gather specific information on educational programs related to nuclear war. Twenty publichealth schools and 240 nursing schools responded. Nuclear war-related content was most likely to appear in disaster nursing and in environmental health courses. Three schools of publichealth report that they currently offer elective courses on nuclear war. Innovative curricula included political action projects for nuclear war prevention.

This article summarizes several health initiatives in Kansas that are being forwarded by way of public/private partnerships. Consensus is being shaped on the standardization of health data and use of actionable indicators. Statewide publichealth improvement planning is also being pursued. A group of large employers and state agencies are creating a basis for group purchasing, consumer assessments of health plans, and coordinated public policy formulation.

Waterborne outbreaks of Toxoplasma gondii have focused attention on the importance of oocysts shed in the feces of infected cats. Cat feces deposited annually into the environment in the United States total approximately 1.2 million metric tons. The annual oocyst burden measured in community surveys is 3 to 434 oocysts per square foot and is greater in areas where cats selectively defecate. Because a single oocyst can possibly cause infection, this oocyst burden represents a major potential publichealth problem. The proper disposal of cat litter, keeping cats indoors, reducing the feral cat population, and protecting the play areas of children might potentially reduce the oocyst burden.

More than 25 years have passed since the release of the Ottawa Charter for Health Promotion. This document represented a substantial contribution to publichealth in its emphasis on the economic, legal, political and cultural factors that influence health. With publichealth renewal underway across Canada, and despite overwhelming support in the publichealth community for the Ottawa Charter, how much its principles will be included in the renewal process remains unclear. In this paper, we present the historical understanding of health promotion in Canada, namely highlighting the contributions from the Lalonde Report, Alma Ata Declaration, the Ottawa Charter for Health Promotion and the more recent population health movement. We discuss publichealth renewal, using the province of British Columbia in Canada as an example. We identify the potential threats to health promotion in publichealth renewal as it unfolds.

Publichealth's reliance on law to define and carry out public activities makes it impossible to define a set of ethical principles unique to publichealth. Publichealth ethics must be encompassed within--and consistent with--a broader set of principles that define the power and limits of governmental institutions. These include human rights, health law, and even medical ethics. The human right to health requires governments not only to respect individual human rights and personal freedoms, but also, importantly, to protect people from harm from external sources and third parties, and to fulfill the health needs of the population. Even if human rights are the natural language for publichealth, not all publichealth professionals are comfortable with the language of human rights. Some argue that individual human rights--such as autonomy and privacy--unfairly limit the permissible means to achieve the goal of health protection. We argue that publichealth should welcome and promote the human rights framework. In almost every instance, this will make publichealth more effective in the long run, because the goals of publichealth and human rights are the same: to promote human flourishing.

Purpose The purpose of this paper is to analyze the institutional and social forces that influence collaborative data sharing practices in cross-sector interorganizational networks. The analysis focusses on the data sharing practices between professionals in the transportation and publichealth sectors, areas prioritized for collaborative action to improve publichealth. Design/methodology/approach A mixed methods design is utilized. Electronic surveys were sent to 57 publichealth and 157 transportation professionals in a large major metropolitan area in the USA (response rate 39.7 percent). Focus groups were held with 12 organizational leaders representing professionals in both sectors. Findings The application of the institutional-social capital framework suggests that professional specialization and organizational forces make it challenging for professionals to develop the cross-sector relationships necessary for cross-sector collaborative data sharing. Research limitations/implications The findings suggest that developing the social relationships necessary for cross-sector collaboration may be resource intensive. Investments are necessary at the organizational level to overcome the professional divides that limit the development of cross-sector relationships critical for collaborative data sharing. The results are limited to the data sharing practices of professionals in one metropolitan area. Originality/value Despite mandates and calls for increased cross-sector collaboration to improve publichealth, such efforts often fail to produce true collaboration. The study's value is that it adds to the theoretical conceptualization of collaboration and provides a deeper understanding as to why collaborative action remains difficult to achieve. Future study of collaboration must consider the interaction between professional specialization and the social relationships necessary for success.

Developing countries have been peasant societies. The cities in traditional societies have been pilgrimage centres, seats of administration and educational centres. These cities had homogeneous relationships with the villages. Industrialization has developed modern megacities whose way of life is heterogeneous with that in the villages. Rural poverty has pushed villagers to the cities, which were never planned to accommodate immigrants. Publichealth and social problems have arisen lowering the quality of life. Communicable diseases among the urban poor coexist with non-communicable diseases among the comparatively affluent. Problems of pollution, crime and chronic morbidity increase. The NGOs provide relief to the poor and needy but do nothing toward creating an infrastructure for balanced development. The election of women as a result of non-discriminatory legislation provides good ground for hope.

Model publichealth laws (publichealth laws or private policies publicly recommended by at least 1 organization for adoption by government bodies or by specified private entities) are promoted as exemplary. We assessed the information sponsors of model publichealth laws provide on the methods used in developing their models and on their models’ adoption and effectiveness. Through a systematic search, we identified 107 model publichealth laws published from 1907 to 2004. As of our assessment in 2005, only 18 (44%) of the sponsors presented any information on the procedures and evidence used in developing their model publichealth laws; information on adoption was provided for only 7 (6.5%) model laws. No sponsors provided information on model effectiveness. We recommend sponsors improve their disclosure of information about the methods and evidence used in developing model publichealth laws and about their adoption and effectiveness. PMID:17413072

Publichealth relies on data reported by health care partners, and information technology makes such reporting easier than ever. However, data are often structured according to a variety of different terminologies and formats, making data interfaces complex and costly. As one strategy to address these challenges, health information organizations (HIOs) have been established to allow secure, integrated sharing of clinical information among numerous stakeholders, including clinical partners and publichealth, through health information exchange (HIE). We give detailed descriptions of 11 typical cases in which HIOs can be used for publichealth purposes. We believe that HIOs, and HIE in general, can improve the efficiency and quality of publichealth reporting, facilitate publichealth investigation, improve emergency response, and enable publichealth to communicate information to the clinical community. PMID:21330598

Publichealth nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of PublicHealth, and the Scope and Standards of PublicHealth Nursing. Human rights and Rights-based care in publichealth nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to publichealth practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Publichealth nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations.

School nurses (SNs) use publichealth nursing knowledge and skills to provide nursing services to school populations. The PublicHealth Intervention Wheel is a practice framework that can be used to explain and guide publichealth nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic survey on their use of publichealth interventions as defined by the wheel. Although 67% of the participants were not familiar with the PublicHealth Intervention Wheel, respondents reported conducting activities that were consistent with the Wheel interventions. Screening, referral and follow-up, case management, and health teaching were the most frequently performed interventions. Intervention use varied by educational level, age of nurse, years of practice, and student population. The PublicHealth Intervention Wheel is a relevant and useful framework that provides a language to explain population-based school nursing practice.

JPRS: ^472 21 March 1961 PUBLICHEALTH AND MIDWIFERY IN INDONESIA 3y M. Joedono DISTRIBUTION STATEMENT A Approved for Public Release...established to service the translation and research needs of the various government departments. ,-^’ JPRS: J^72 CSO: 1335-S/d PUBLICHEALTH AND MIDWIFERY

Reducing harm from drug use lies at the intersection of publichealth, public policy, politics and policing. In an ideal world, evidence of publichealth gains achievable through new approaches or technologies should inform public policy, should help shape political agendas in support of policy change, which should translate into law and regulations – and then to their application. The goal of this transformative process should be to yield the highest attainable health benefits to vulnerable individuals and communities and to society as a whole. PMID:22769027

The personality trait of neuroticism refers to relatively stable tendencies to respond with negative emotions to threat, frustration, or loss. Individuals in the population vary markedly on this trait, ranging from frequent and intense emotional reactions to minor challenges to little emotional reaction even in the face of significant difficulties. Although not widely appreciated, there is growing evidence that neuroticism is a psychological trait of profound publichealth significance. Neuroticism is a robust correlate and predictor of many different mental and physical disorders, comorbidity among them, and the frequency of mental and general health service use. Indeed, neuroticism apparently is a predictor of the quality and longevity of our lives. Achieving a full understanding of the nature and origins of neuroticism, and the mechanisms through which neuroticism is linked to mental and physical disorders, should be a top priority for research. Knowing why neuroticism predicts such a wide variety of seemingly diverse outcomes should lead to improved understanding of commonalities among those outcomes and improved strategies for preventing them.

The environment continues to be a source of ill-health for many people, particularly in developing countries. International environmental law offers a viable strategy for enhancing publichealth through the promotion of increased awareness of the linkages between health and environment, mobilization of technical and financial resources, strengthening of research and monitoring, enforcement of health-related standards, and promotion of global cooperation. An enhanced capacity to utilize international environmental law could lead to significant worldwide gains in publichealth. PMID:12571726

Background Global publichealth today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of PublicHealth Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt publichealth to its future role in global health. Design A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results Stakeholders underscored that global publichealth today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging publichealth in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and publichealth reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of publichealth. Resources should be allocated in a sustainable and accountable way. Publichealth professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions The study highlighted some of the main publichealth challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating publichealth at the global level and should lead

Background Global publichealth today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of PublicHealth Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt publichealth to its future role in global health. Design A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results Stakeholders underscored that global publichealth today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging publichealth in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and publichealth reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of publichealth. Resources should be allocated in a sustainable and accountable way. Publichealth professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions The study highlighted some of the main publichealth challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating publichealth at the global level and should lead

Evaluating the potential health impacts of chemical, physical, and biological environmental factors represents a challenging task with profound medical, publichealth, and historical implications. The history of publichealth is replete with instances, ranging from tobacco to lead and asbestos, where the ability to obtain evidence on potential…

The Institute of Medicine concluded that keeping the public healthy required a well-educated publichealth workforce, thus leading to its recommendation that "all undergraduates should have access to education in publichealth" [2]. In response to this call, the authors examined the current practice, feasibility, and value in strengthening (or building) a functional collaborative model between academic institutions and practitioners from local health departments to educate tomorrow's publichealth workforce. Local and regional health departments in New England were surveyed to: (1) establish a baseline of existing working relationships between them and nearby academic institutions; (2) examine the barriers that inhibit the development of collaborations with academic partners; (3) assess how they jointly promote publichealth workforce development; and (4) analyze which essential publichealth services their partnership addresses. Despite the lack of financial resources often cited for the absence of academic-local health department collaborations, some New England states reported that their academic institution and local publichealth department partnerships were valued and productive. The authors discuss how effective academic-community collaborations have the potential to facilitate a broad-based appreciation of publichealth among students via a wide array of publichealth curricula and applied experiential learning opportunities in publichealth settings. The authors propose a model for how to combine basic publichealth lessons with practical experience and leadership offered by local health departments, in order to foster a real understanding of publichealth, its importance, practice, and relevance in today's society from a publichealth workforce perspective.

Competency-based education for publichealth professionals has been recommended by the Institute of Medicine. The Association of Schools of PublicHealth has developed a set of academic core competencies that it recommends that all Master of PublicHealth (MPH) students should possess prior to graduation. This article discusses the processes and reasoning used by the workgroup that prepared the epidemiology subset of MPH core competencies that appear in the association's 2006 report. These academic core competencies are complementary to but distinct from the specialist competencies that students should develop in their major field. The authors emphasize the importance of ongoing refinement of the core competency model with participation from both publichealth academics and publichealth practitioners.

Obesity is a majorpublichealth concern worldwide. Because individual-level interventions have been unsuccessful at curbing obesity rates, there is an emphasis on publichealth approaches. In addition to testing the effectiveness of any publichealth interventions, it is important to consider the ethical implications of these interventions in order to protect the public's rights and promote overall well-being. In this paper, we review publichealth approaches to obesity in three broad domains (changes to the socio-communicative environment, changes to the economic environment, and changes to the physical environment/access) and consider the potential ethical issues that arise in each of those domains. We suggest that interventions that target the physical environment/access (making it easier for people to engage in healthy behaviors), that target the entire population (rather than just individuals with obesity), and that focus on health behaviors (rather than on weight) have the least potential for ethical concerns.

In this paper, I describe how publichealth officers in Japan in the period of the late Taisho and early Showa eras claimed their position as professionals in the sanitary administrations of central and local governments. In the background of this push for recognition, there were related international and national movements. Internationally, publichealth ministries were established in developed countries and the League of Nations Health Organization (LNHO) was created. LNHO wanted to improve the level of publichealth officials world-wide, so the organization sponsored international exchanges of officials. These activities made a strong impression on Japanese publichealth officials, who realized that they belonged to an internationally recognized profession and that they needed to work hard to improve the substandard Japanese publichealth situation. Meanwhile, at the level of domestic politics, there were several movements of technical experts in different fields of government administration that worked to fight the unfair treatment of administrative officials, a situation that had existed since Meiji Period. The publichealth officers collaborated with the other technical experts to improve their positions and to play key roles in society. But while the other technical experts actively pursued social leadership, publichealth officials wanted to remain scientists. This is because the sanitary departments in the local governments were organized within police departments. In this environment, the law was dominant and science was secondary. But publichealth officials insisted that the basis of publichealth should be science, so they emphasized their scientific expertise.

Once viewed primarily as a criminal justice problem, violence and its prevention are now often claimed by publichealth professionals as being within their purview. The author reviewed 282 articles published in publichealth and medical journals from 1985 through 1995 that discussed violence as a publichealth problem. She found that while authors tended to identify social and structural causes for violence, they suggested interventions that targeted individuals' attitudes or behaviors and improved publichealth practice. Her study illuminates the tension between publichealth professionals' vision of the social precursors of violence and their attempts to apply a traditional set of remedies. In targeting individuals to rid the nation of violence, the publichealth community is deemphasizing societal causes. Images p[498]-a p499-a p500-a p501-a p502-a p503-a p504-a p506-a PMID:9847921

American Indian/Alaska Native tribal governments are sovereign entities with inherent authority to create laws and enact health regulations. Laws are an essential tool for ensuring effective publichealth responses to emerging threats. To analyze how tribal laws support publichealth practice in tribal communities, we reviewed tribal legal documentation available through online databases and talked with subject-matter experts in tribal publichealth law. Of the 70 tribal codes we found, 14 (20%) had no clearly identifiable publichealth provisions. The public health–related statutes within the remaining codes were rarely well integrated or comprehensive. Our findings provide an evidence base to help tribal leaders strengthen publichealth legal foundations in tribal communities. PMID:19150897

Human resources education for health workers has been predominantly discipline-oriented and fragmented, influencing research design and, in turn, scientific output. Several authors argue that university education should transition from disciplinarity to transdisciplinarity. To gather the theoretical underpinnings for this subject of international interest, a literature search was conducted in the PubMed, EBSCO, and SciELO databases in 2012, using the terms "transdisciplinary and translational research" in Spanish and English. The majority of authors believe that identifying problems from different perspectives by specialists and community members and leaders will be conducive to more effective intersectoral interventions. They suggest undertaking organizational change to reshape reshaping work styles and self-organizational forms of scientific activity. Finally, a transdisciplinary model for publichealth research has been proposed that is based on traditional project design tools, but with variations borrowed from a complex systems approach.

The Institute of Medicine's The Future of PublicHealth calls for a strengthening of linkages between publichealth and mental health, with a view to integrating the functions at the service delivery level. This paper details the history of the mental health/publichealth interface in Baltimore, Maryland. In 1977, mental health and addiction services were merged into the Department of Health. More recently, in 1988 adult mental health services were split off into a quasi-public corporation. Children's mental health, however, was retained as a distinct service within the Department of Health in order to enhance coordination with other health services for children. Replication of such coordinated-care models is certainly feasible.

The history of life is marked by a small number of major transitions, whether viewed from a genetic, ecological, or geological perspective. Specialists from various disciplines have focused on the packaging of information to generate new evolutionary individuals, on the expansion of ecological opportunity, or the abiotic drivers of environmental change to which organisms respond as the major drivers of these episodes. But the critical issue for understanding these major evolutionary transitions (METs) lies in the interactions between environmental, ecologic, and genetic change. Here, I propose that public goods may serve as one currency of such interactions: biological products that are non-excludable and non-rivalrous. Such biological public goods may be involved in either the generation of new evolutionary variation, as with genetic sequences that are easily transferred between different microbial lineages, or in the construction of new ecological niches, as with the progressive oxygenation of the oceans and atmosphere. Attention to public goods emphasizes the processes by which organisms actively construct their own evolutionary opportunities. Such public goods may have facilitated some METs.

The famous preamble to the Constitution of the World Health Organization (WHO) from 1948, stating that health is not only the absence of disease, has been one of the most influential political statements of our time. The follow-up, reaching a position where health is viewed as instrumental to a good life and not as a goal in itself, as set out in the Ottawa Charter of 1986, has likewise been of the utmost importance for the global development of publichealth, as well as developing the concept of health promotion. The focus on publichealth sparked by the WHO was paralleled by expansion of the academic interest in the topic, beginning in the USA and successively adopted around the world. In the Nordic countries the pioneering of an academic platform for publichealth studies and research began in 1953. This was later followed by a stepwise expansion to a full academic institution with postgraduate studies, work-related training, research and development. From the start, the resultant institution called the Nordic School of PublicHealth (NHV) was a joint Nordic project financed by the Nordic governments. The NHV became a leader in publichealth studies in Nordic countries and also a role model for the development of an academic community. A large campus and a select and erudite staff, together with thousands of students, paved the way for the NHV having a major impact on publichealth policy in Nordic countries. One effect of this was increasing awareness of the need for systematic policy supporting publichealth research and, with this, the founding of institutions of publichealth in all of the separate Nordic countries. Ironically, the impact made by the NHV in spreading the idea of publichealth as an important part of academic study has made the NHV superfluous. It is true that courses and programmes in publichealth are now available at most universities in the five Nordic countries, but they are directed at young students fresh from high school. There is no

Health care will continue to occupy a prominent place in state legislative deliberations, as indicated by the National Conference of State Legislatures' 1987 State Issues Survey. The survey addressed state actions in these health issue areas: (1) health care for the medically indigent; (2) medical malpractice; (3) certificate of need and health…

It is unnecessary and counterproductive to sacrifice basic human rights to respond to bioterrorism. Constructive publichealth legislation, which must be federal, cannot be carefully drafted under panic conditions. When it is, like the "model act," it will predictably rely on broad, arbitrary state authority exercised without public accountability. Publichealth should resist reverting to its nineteenth-century practices of forced examination and quarantine, which will simply encourage people to avoid physicians, hospitals, and publichealth practitioners they now trust and actively seek out in emergencies. Upholding human rights is essential to public trust and is ultimately our best defense against the threat of terrorism in the twenty-first century.

Publichealth research is an integral part of the study of congenital heart disease. While this type of research has become more popular, particularly over the past decade, it has a history that stretches back to almost the beginnings of pediatric cardiology as a field. This review aims to introduce the concepts and methodologies of publichealth and how they relate to congenital heart disease, describe some of the challenges of traditional research methods in congenital heart disease, describe the history of publichealth research, and demonstrate the relevance of publichealth research, particularly databases, to pediatric cardiology fellows.

Ethical issues that can arise in distinguishing publichealth research from practice are highlighted in 2 case studies—an investigation of a tuberculosis outbreak in a prison and an evaluation of a program for improving HIV prevention services. Regardless of whether such publichealth investigations represent research or practice, we see a need for ethics oversight procedures that reflect actual risks and enable timely responses to crises. Such oversight should accommodate the perspectives of persons and communities affected by publichealth threats and by governmental responses to those threats; it should further recognize that publichealth ethics is a distinct field combining bioethics, political philosophy, human rights, and law. PMID:15249291

This article reviews the fiscal, programmatic, clinical, and cultural forces of health care reform that are transforming the work of public psychiatrists. Areas of rapid change and issues of concern are discussed. A proposed health care reform agenda for public psychiatric leadership emphasizes (1) access to quality mental health care, (2) promotion of recovery practices in primary care, (3) promotion of public psychiatry values within general psychiatry, (4) engagement in national policy formulation and implementation, and (5) further development of psychiatric leadership focused on public and community mental health.

At the Nordic School of PublicHealth (NHV), methods to alleviate problems with disability have been seen as an important part of actions to support publichealth. A programme for universal design was started in 2006. Some issues of publichealth perspectives on disability are presented in this paper, based on discussions from a PhD course held at the NHV. During the course, the students presented papers in which they reflected on the relationship between disability and publichealth. These essays were collected and published in 2012 at NHV.

Accurate information on how much the United States spends on publichealth is critical. These estimates affect planning efforts; reflect the value society places on the publichealth enterprise; and allows for the demonstration of cost-effectiveness of programs, policies, and services aimed at increasing population health. Yet, at present, there are a limited number of sources of systematic publichealth finance data. Each of these sources is collected in different ways, for different reasons, and so yields strikingly different results. This article aims to compare and contrast all 4 current national publichealth finance data sets, including data compiled by Trust for America's Health, the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), and the Census, which underlie the oft-cited National Health Expenditure Account estimates of publichealth activity. In FY2008, ASTHO estimates that state health agencies spent $24 billion ($94 per capita on average, median $79), while the Census estimated all state governmental agencies including state health agencies spent $60 billion on publichealth ($200 per capita on average, median $166). Census publichealth data suggest that local governments spent an average of $87 per capita (median $57), whereas NACCHO estimates that reporting LHDs spent $64 per capita on average (median $36) in FY2008. We conclude that these estimates differ because the various organizations collect data using different means, data definitions, and inclusion/exclusion criteria--most notably around whether to include spending by all agencies versus a state/local health department, and whether behavioral health, disability, and some clinical care spending are included in estimates. Alongside deeper analysis of presently underutilized Census administrative data, we see harmonization efforts and the creation of a standardized expenditure reporting system as a way to

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support publichealth practice. The potential benefits to disease monitoring, disaster response, and other publichealth activities served as an important justification for the US' investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local publichealth practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified publichealth efforts and activities that were improved by participation in HIE. HIE supported publichealth activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in publichealth.

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support publichealth practice. The potential benefits to disease monitoring, disaster response, and other publichealth activities served as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local publichealth practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified publichealth efforts and activities that were improved by participation in HIE. HIE supported publichealth activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in publichealth. PMID:25954386

The proliferation of community-based health education programs has outpaced the knowledge base of behavior change strategies that are appropriate for publichealth interventions. This article discusses eight essential aspects of the social marketing process. (JOW)

The increase in the number of antibiotic resistant bacteria represents a major danger for the health of humans and animals. Combined with an almost complete absence of new antibiotics, it is one of the most alarming publichealth issues of our time. Measures must be taken in order to control the use of these drugs and safeguard their effectiveness.

A dip and peak pattern of suicide around majorpublic holidays has been found in developed countries and explained by the broken promise effect. Focusing on two major holidays in South Korea (New Year's Day and Thanksgiving Day, both on the lunar calendar), replication of the dip and peak pattern was done by analyzing individual information on all suicides from 1997 to 2014. The replicated pattern revealed the most vulnerable group to be married men aged 50+ in nonmetropolitan areas in 2006-2014. Families, friends, and policy makers can use these findings to save the vulnerable.

Medical progress has enabled achievements that were not even thinkable earlier but at the same time society and publichealth have had to face new challenges. What are we ready to accept in the area of human reproduction? This paper aims at ethical analysis of Bulgarian laws on reproduction. The abortion debate nowadays has got new dimiension focusing not that much on its moral acceptability but rather on the acceptable indications for its performance. Is it ethical to perform abortion in case of undesired gender of the embryo or genetic malformations? Lots of moral issues mark the area of assisted reproduction which is due to the separation of the reproductive functions (ova, sperm and embryo donation, surrogacy), fragmentation of motherhood and fatherhood, differentiation of biological and social parenthood. Defining limits of acceptable interference or non-interference in human reproduction will never be easy, but dynamics of moral judgment shouldn't bother us. The rigidity of moral norms is what should be alarming because it threatens procreative autonomy.

Drug use is a publichealth problem associated with high mortality and morbidity, and is often accompanied by suboptimal engagement in health care. Harm reduction is a pragmatic publichealth approach encompassing all goals of publichealth: improving health, social well-being, and quality of life. Harm reduction prioritizes improving the lives of people who use drugs in partnership with those served without a narrow focus on abstinence from drugs. Evidence has shown that harm reduction oriented practice can reduce transmission of blood-borne illnesses, and other injection related infections, as well as preventing fatal overdose.

There is scientific consensus that the global climate is changing, with rising surface temperatures, melting ice and snow, rising sea levels, and increasing climate variability. These changes are expected to have substantial impacts on human health. There are known, effective publichealth responses for many of these impacts, but the scope, timeline, and complexity of climate change are unprecedented. We propose a publichealth approach to climate change, based on the essential publichealth services, that extends to both clinical and population health services and emphasizes the coordination of government agencies (federal, state, and local), academia, the private sector, and nongovernmental organizations. PMID:18235058

The library is a relatively safe work place, but no place is completely free from hazards. This paper examines the majorhealth and safety concerns of staff and patrons of academic and public libraries, based on a literature review of approximately 60 articles. According to this literature, general safety hazards are not considered a major problem…

High-volume horizontal hydraulic fracturing (HVHF) in unconventional gas reserves has vastly increased the potential for domestic natural gas production. HVHF has been promoted as a way to decrease dependence on foreign energy sources, replace dirtier energy sources like coal, and generate economic development. At the same time, activities related to expanded HVHF pose potential risks including ground- and surface water contamination, climate change, air pollution, and effects on worker health. HVHF has been largely approached as an issue of energy economics and environmental regulation, but it also has significant implications for publichealth. We argue that publichealth provides an important perspective on policymaking in this arena. The American PublicHealth Association (APHA) recently adopted a policy position for involvement of publichealth professionals in this issue. Building on that foundation, this commentary lays out a set of five perspectives that guide how publichealth can contribute to this conversation.

The majority of publichealth programmes are based in schools, places of employment and in community settings. Likewise, nearly all health-care interventions occur in clinics and hospitals. An underdeveloped area for publichealth-related planning that carries international implications is the cultural heritage sector, and specifically museums and art galleries. This paper presents a rationale for the use of museums and art galleries as sites for publichealth interventions and health promotion programmes through discussing the social role of these organisations in the health and well-being of the communities they serve. Recent research from several countries is reviewed and integrated into a proposed framework for future collaboration between cultural heritage, health-care and university sectors to further advance research, policy development and evidence-based practice.

There is growing recognition that health goals are more likely to be achieved and sustained if programs are complemented by appropriate changes in the policies, systems, and environments that shape their communities. However, the knowledge, skills, and abilities needed to create and implement policy are among the major needs identified by practitioners at both the state and local levels. This article describes the structure and content of the Nebraska Health Policy Academy (the Academy), a 9-month program developed to meet the demand for this training. The Academy is a competency-based training program that aims to increase the capacity of Nebraska's state and local publichealth staff and their community partners to use publichealth policy and law as a publichealth tool. Our initiative allows for participation across a large, sparsely populated state; is grounded in adult learning theory; introduces the key principles and practices of policy, systems, and environmental change; and is offered free of charge to the state's publichealth workforce. Challenges and lessons learned when offering workforce development on publichealth policy efforts are discussed.

In publichealth, the generation, management, and transfer of knowledge all need major improvement. Problems in generating knowledge include an imbalance in research funding, publication bias, unnecessary studies, adherence to fashion, and undue interest in novel and immediate issues. Impaired generation of knowledge, combined with a dated and inadequate process for managing knowledge and an inefficient system for transferring knowledge, mean a distorted body of evidence available for decisionmaking in publichealth. This article hopes to stimulate discussion by proposing a Global Registry of Anticipated PublicHealth Studies. This prospective, comprehensive system for tracking research in publichealth could help enhance collaboration and improve efficiency. Practical problems must be discussed before such a vision can be further developed. PMID:17413073

Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its publichealth implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their publichealth implications. On the basis of current findings, we propose that weight stigma is not a beneficial publichealth tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for publichealth. PMID:20075322

New psychoactive substances (NPS) have completely modified the drug scene and the current landscape of addiction. Synthetic substances, such as substituted or synthetic cathinones, also known as « legal highs », are often produced and used to mimic the effects of controlled drugs such as cocaine, methylenedioxymethamphetamine (MDMA, ecstasy), and methamphetamine. The overwhelming majority of synthetic cathinones are produced in China and South East Asian countries. The Internet has emerged as the new marketplace for NPS, playing a major role in providing information on acquisition, synthesis, extraction, identification, and substance use. All these compounds are intentionally mislabeled and sold on-line under slang terms such as bath salts, plant food, plant feeders and research chemicals. They are sometimes labeled « not for human use » or « not tested for hazards or toxicity ». The rapid spread of NPS forces member countries of the European Union to adapt their response to the potential new dangers that may cause. To date, not only health actors but also the general public need to be clearly informed and aware of dangers resulting from NPS spread and use. Here, we review the major clinical effects of synthetic cathinones to highlight their impact on publichealth. A literature search was conducted from 2009 to 2014 based on PubMed, Google Scholar, Erowid, and governmental websites, using the following keywords alone or in combination: “new psychoactive substances”, “synthetic cathinones”, “substituted cathinones”, “mephedrone”, “methylone”, “MDPV”, “4-MEC”, “addiction”, and “substance use disorder”. PMID:26074740

Despite the Canadian publichealth community's commitments to promoting public policy that supports health, evidence indicates that Canada's publichealth picture continues to decline. This may be due in part to the failure of publichealth agencies and local publichealth units to engage in public policy advocacy and public education about the social determinants of health. Examples of such activities by local publichealth units are now available and provide a model for such activity.

Palliative care is an emerging specialist discipline worldwide with the majority of services located in developed countries. Developing countries, however, have higher incidences of cancer and AIDS and most of these patients would benefit from palliative care. While there is prominent coverage of this issue in the palliative care literature, there is limited coverage in the specialist publichealth literature, which suggests that the challenges of palliative care may not yet have been generally recognized as a publichealth priority, particularly in developing countries. The aim of this article is to introduce the topic of "Palliative care in developing countries" into the specialist publichealth literature to raise awareness and stimulate debate on this issue among publichealth professionals and health policy makers, thereby potentially facilitating establishment of palliative care services in developing countries.

This curriculum guide serves to assist faculty who are developing undergraduate courses in publichealth as well as educational administrators and faculty curriculum committees who are designing undergraduate publichealth curricula. The approach outlined in these recommendations focuses on the development of three core courses, each of which is…

NERL's Human Exposure and Atmospheric Sciences Division and other participants in the PublicHealth Air Surveillance Evaluation (PHASE) project will be presenting their results to the Environmnetal PublicHealth Tracking (EPHT) workshop in Tampa FL. The PHASE project is a collab...

Physical inactivity is a serious publichealth problem that is associated with numerous preventable diseases. Publichealth concerns, particularly those related to the increased prevalence of overweight, obesity, and diabetes, call for schools to become proactive in the promotion of healthy, physically active lifestyles. This article begins by…

The preservation of the public's health is one of the most important goals of government. The enactment and enforcement of law is the primary means by which government can encourage as well as compel conditions for healthier and safer lifestyles. The Law creates and assigns functions for publichealth authorities. In this regard, law is a fundamental element of effective publichealth policy and practice. It has played a crucial role in many of publichealth's greatest achievements. In spite of its contribution to effective PublicHealth practice, the potential for the application of law to chronic disease prevention and control is yet to be fully recognized. The development and implementation of legal frameworks could broaden the range of effective publichealth strategies and provide valuable tools for the publichealth workforce. In order to expand the range of effective publichealth interventions, the government should use the law as a tool to achieve the goal of preventing chronic diseases and ameliorate the growing epidemic of obesity, heart disease, stroke, cancer and other chronic diseases and their risk factors.

Department of Health , Education, and Welfare, Washington., DC. Office of the Secretary.

For potential grant applicants and for the general public, the booklet describes the programs of the six PublicHealth Service agencies in the American health care system. Each program is described concisely in terms of: its purpose and legal basis; applicants' eligibility for grants and the basis for their award; the special requirements made of…

Publichealth has considerable capacity to reduce the drag of health spending on our nation by preventing the leading causes of disease, death, and disability with cost-efficient, population-based interventions and innovative, boundary-spanning approaches that link clinical care and community prevention. Publichealth is uniquely able to identify the burdens of disease and analyze the best strategies for addressing them. A 3-pronged strategy can help assure the value needed from our publichealth investments. First, we must center our efforts on prevention. Second, we must optimize our publichealth investments to achieve the greatest value for our investment. Third, publichealth must collaborate with traditional and new partners on initiatives and in funding. How we finance publichealth is critical to maximizing publichealth's benefits and requires thoughtful analysis of how federal funding affects state and local health agencies' programming and how allocation drives choices and design, among other topics, as discussed in this special issue of the journal.

Context For three decades, experts have been stressing the importance of law to the effective operation of publichealth systems. Most recently, in a 2011 report, the Institute of Medicine recommended a review of state and local publichealth laws to ensure appropriate authority for publichealth agencies; adequate access to legal counsel for publichealth agencies; evaluations of the health effects and costs associated with legislation, regulations, and policies; and enhancement of research methods to assess the strength of evidence regarding the health effects of public policies. These recommendations, and the continued interest in law as a determinant of health system performance, speak to the need for integrating the emerging fields of PublicHealth Law Research (PHLR) and PublicHealth Systems and Services Research (PHSSR). Methods Expert commentary. Findings This article sets out a unified framework for the two fields and a shared research agenda built around three broad inquiries: (1) the structural role of law in shaping the organization, powers, prerogatives, duties, and limitations of publichealth agencies and thereby their functioning and ultimately their impact on publichealth (“infrastructure”); (2) the mechanisms through which publichealth system characteristics influence the implementation of interventional publichealth laws (“implementation”); and (3) the individual and system characteristics that influence the ability of publichealth systems and their community partners to develop and secure enactment of legal initiatives to advance publichealth (“innovation”). Research to date has laid a foundation of evidence, but progress requires better and more accessible data, a new generation of researchers comfortable in both law and health research, and more rigorous methods. Conclusions The routine integration of law as a salient factor in broader PHSSR studies of publichealth system functioning and health outcomes will enhance the

Scientific and clinical activities undertaken by publichealth agencies may be misconstrued as medical research. Most discussions of regulatory and legal oversight of medical research focus on activities involving either patients in clinical practice or volunteers in clinical trials. These discussions often exclude similar activities that constitute or support core functions of publichealth practice. As a result, publichealth agencies and practitioners may be held to inappropriate regulatory standards regarding research. Through the lens of the Departments of Defense and Veterans Affairs, and using several case studies from these departments, we offer a framework for the adjudication of activities common to research and publichealth practice that could assist publichealth practitioners, research oversight authorities, and scientific journals in determining whether such activities require regulatory review and approval as research.

Homicide is seven times as common among U.S. non-Hispanic Black as among non-Hispanic White youth ages 15 to 24 years. In 83% of these youth homicides, the murder weapon is a firearm. Yet, for more than a decade, the national publichealth position on youth violence has been largely silent about the role of firearms, and tools used by publichealth professionals to reduce harm from other potential hazards have been unusable where guns are concerned. This deprives already underserved populations from the full benefits publichealth agencies might be able to deliver. In part, political prohibitions against research about direct measures of firearm control and the absence of valid publichealth surveillance are responsible. More refined epidemiologic theories as well as traditional publichealth methods are needed if the U.S. aims to reduce disparate Black-White youth homicide rates.

Scientific and clinical activities undertaken by publichealth agencies may be misconstrued as medical research. Most discussions of regulatory and legal oversight of medical research focus on activities involving either patients in clinical practice or volunteers in clinical trials. These discussions often exclude similar activities that constitute or support core functions of publichealth practice. As a result, publichealth agencies and practitioners may be held to inappropriate regulatory standards regarding research. Through the lens of the Departments of Defense and Veterans Affairs, and using several case studies from these departments, we offer a framework for the adjudication of activities common to research and publichealth practice that could assist publichealth practitioners, research oversight authorities, and scientific journals in determining whether such activities require regulatory review and approval as research. PMID:24524499

Complex systems abound in publichealth. Complex systems are made up of heterogeneous elements that interact with one another, have emergent properties that are not explained by understanding the individual elements of the system, persist over time and adapt to changing circumstances. Publichealth is starting to use results from systems science studies to shape practice and policy, for example in preparing for global pandemics. However, systems science study designs and analytic methods remain underutilized and are not widely featured in publichealth curricula or training. In this review we present an argument for the utility of systems science methods in publichealth, introduce three important systems science methods (system dynamics, network analysis, and agent-based modeling), and provide three case studies where these methods have been used to answer important publichealth science questions in the areas of infectious disease, tobacco control, and obesity. PMID:22224885

Recognition of petroleum as a finite global resource has spurred increasing interest in the intersection between petroleum scarcity and publichealth. Local health departments represent a critical yet highly vulnerable component of the publichealth infrastructure. These frontline agencies currently face daunting resource constraints and rely heavily on petroleum for vital population-based health services. Against this backdrop, petroleum scarcity may necessitate reconfiguring local publichealth service approaches. We describe the anticipated impacts of petroleum scarcity on local health departments, recommend the use of the 10 Essential PublicHealth Services as a framework for examining attendant operational challenges and potential responses to them, and describe approaches that local health departments and their stakeholders could consider as part of timely planning efforts. PMID:21778471

Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers publichealth practitioners an opportunity to address an important social determinant of health. Publichealth has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire hazards to decrease injuries. Today, publichealth departments can employ multiple strategies to improve housing, such as developing and enforcing housing guidelines and codes, implementing “Healthy Homes” programs to improve indoor environmental quality, assessing housing conditions, and advocating for healthy, affordable housing. Now is the time for publichealth to create healthier homes by confronting substandard housing. PMID:11988443

General moral (ethical) principles play a prominent role in certain methods of moral reasoning and ethical decision-making in bioethics and publichealth. Examples include the principles of respect for autonomy, beneficence, nonmaleficence, and justice. Some accounts of ethics in publichealth have pointed to additional principles related to social and environmental concerns, such as the precautionary principle and principles of solidarity or social cohesion. This article provides an overview of principle-based methods of moral reasoning as they apply to publichealth ethics including a summary of advantages and disadvantages of methods of moral reasoning that rely upon general principles of moral reasoning. Drawing upon the literature on publichealth ethics, examples are provided of additional principles, obligations, and rules that may be useful for analyzing complex ethical issues in publichealth. A framework is outlined that takes into consideration the interplay of ethical principles and rules at individual, community, national, and global levels. Concepts such as the precautionary principle and solidarity are shown to be useful to publichealth ethics to the extent that they can be shown to provide worthwhile guidance and information above and beyond principles of beneficence, nonmaleficence, and justice, and the clusters of rules and maxims that are linked to these moral principles. Future directions likely to be productive include further work on areas of publichealth ethics such as public trust, community empowerment, the rights of individuals who are targeted (or not targeted) by publichealth interventions, individual and community resilience and wellbeing, and further clarification of principles, obligations, and rules in publichealth disciplines such as environmental science, prevention and control of chronic and infectious diseases, genomics, and global health. PMID:20072707

A theoretical reflection on publichealth from a standpoint of social justice, which does not overlook the individual, is presented. Based on a conceptualization of social justice, human rights and health in the framework of an epistemological analysis, a particular perspective on social justice and its implications for publichealth praxis, using a publichealth program as an example, is revealed. Some routes are identified in order to orient and put into practice the actions developed in publichealth programs. This requires a different way of understanding the scenarios and interchanges among people in the field of clinical practice. It is understood that these fields can also be seen as a suitable opportunity for the establishment of individuals and individualities committed to the political struggle for human rights, equity in health and recognition of a life worthy of human dignity.

Since CDC acquired its first mainframe computer in 1964, the use of information technology in publichealth practice has grown steadily and, during the past 2 decades, dramatically. Publichealth informatics (PHI) arrived on the scene during the 1990s after medical informatics (intersecting information technology, medicine, and health care) and bioinformatics (intersecting mathematics, statistics, computer science, and molecular biology). Similarly, PHI merged the disciplines of information science and computer science to publichealth practice, research, and learning. Using strategies and standards, practitioners employ PHI tools and training to maximize health impacts at local, state, and national levels. They develop and deploy information technology solutions that provide accurate, timely, and secure information to guide publichealth action.

Twenty-first-century trade policy is complex and affects society and population health in direct and indirect ways. Without doubt, trade policy influences the distribution of power, money, and resources between and within countries, which in turn affects the natural environment; people's daily living conditions; and the local availability, quality, affordability, and desirability of products (e.g., food, tobacco, alcohol, and health care); it also affects individuals' enjoyment of the highest attainable standard of health. In this article, we provide an overview of the modern global trade environment, illustrate the pathways between trade and health, and explore the emerging twenty-first-century trade policy landscape and its implications for health and health equity. We conclude with a call for more interdisciplinary research that embraces complexity theory and systems science as well as the political economy of health and that includes monitoring and evaluation of the impact of trade agreements on health.

Protecting publichealth requires the acquisition, use, and storage of extensive health-related information about individuals. The electronic accumulation and exchange of personal data promises significant publichealth benefits but also threatens individual privacy; breaches of privacy can lead to individual discrimination in employment, insurance, and government programs. Individuals concerned about privacy invasions may avoid clinical or publichealth tests, treatments, or research. Although individual privacy protections are critical, comprehensive federal privacy protections do not adequately protect publichealth data, and existing state privacy laws are inconsistent and fragmented. The Model State PublicHealth Privacy Act provides strong privacy safeguards for publichealth data while preserving the ability of state and local publichealth departments to act for the common good. PMID:11527765

Enhancing effective preventive interventions to address contemporary publichealth problems requires improved capacity for applied publichealth research. A particular need has been recognized for capacity development in population health intervention research to address the complex multidisciplinary challenges of developing, implementing, and evaluating publichealth practices, intervention programs, and policies. Research training programs need to adapt to these new realities. We have presented an example of a 2003 to 2015 training program in transdisciplinary research on publichealth interventions that embedded doctoral and postdoctoral trainees in publichealth organizations in Quebec, Canada. This university–publichealth partnership for research training is an example of how to link science and practice to meet emerging needs in publichealth. PMID:27854518

Enhancing effective preventive interventions to address contemporary publichealth problems requires improved capacity for applied publichealth research. A particular need has been recognized for capacity development in population health intervention research to address the complex multidisciplinary challenges of developing, implementing, and evaluating publichealth practices, intervention programs, and policies. Research training programs need to adapt to these new realities. We have presented an example of a 2003 to 2015 training program in transdisciplinary research on publichealth interventions that embedded doctoral and postdoctoral trainees in publichealth organizations in Quebec, Canada. This university-publichealth partnership for research training is an example of how to link science and practice to meet emerging needs in publichealth.

Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated publichealth platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for publichealth The landscape of healthcare systems, publichealth systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on publichealth informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to publichealth, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector. PMID:27190977

Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated publichealth platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for publichealthThe landscape of healthcare systems, publichealth systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on publichealth informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to publichealth, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector.

Publichealth personnel are the first-line workers of preventive care and medical services. In the face of rapid social and demographic changes, empowerment and on-job training have become important approaches to enhance the function of nurses. Health centers act like the "peripheral nerves" of the government healthcare system, as they must both reflect the needs of community residents and fully implement government mandated services. While widely distributed, health centers face manpower shortages and disorderly information collection and distribution systems. Empowerment and on-job training programs can enhance public heath staff knowledge in order to cope with heavy workloads and shift toward multi-dimensional development. This paper examines the experience of the New Taipei City PublicHealth Bureau in conducting health center empowerment programs from four perspectives, including personal cultivation and organizational cultivation. It was found that publichealth staff self-recognition of professional values can also be further strengthened through alliances within the community, and that establishing personal relationships with patients by "treating patients as relatives" was effective in realizing health center objectives. This paper also reminds agency supervisors that staff training is a critical management task. Health authorities should thus introduce in a timely manner organizational management, on-job training, service reengineering, and other related corporate philosophies; facilitate staff empowerment; consolidate core professional knowledge; and construct intellectual and social capital that meets health unit needs in order to enhance health center competitiveness and publichealth staff knowledge.

Status epilepticus (SE) is defined as a continuous clinical and/or electrographic seizure activity lasting five minutes or more or recurrent seizure activity without return to baseline. There is a paucity of epidemiological studies of SE, as most research is derived from small population studies. The overall incidence of SE is 9.9 to 41 per 100,000/year, with peaks in children and the elderly and with febrile seizures and strokes as its main etiologies. The etiology is the major determinant of mortality. Governments and the academic community should predominantly focus on the primary prevention of etiologies linked to SE, as these are the most important risk factors for its development. This review describes the incidence, prevalence, etiology, risk factors, outcomes and costs of SE and aims to identify future research and publichealth needs. PMID:27537921

Publichealth ethics is a nascent field, emerging over the past decade as an applied field merging concepts of clinical and research ethics. Because the "patient" in publichealth is the population rather than the individual, existing principles might be weighted differently, or there might be different ethical principles to consider. This paper reviewed the evolution of publichealth ethics, the use of bioethics as its model, and the proposed frameworks for publichealth ethics through 2010. Review of 13 majorpublichealth ethics frameworks published over the past 15 years yields a wide variety of theoretical approaches, some similar foundational values, and a few similar operating principles. Coming to a consensus on the reach, purpose, and ends of publichealth is necessary if we are to agree on what ethical underpinnings drive us, what foundational values bring us to these underpinnings, and what operating principles practitioners must implement to make ethical decisions. If publichealth is distinct enough from clinical medicine to warrant its own set of ethical and philosophical underpinnings, then a decision must be made as to whether a single approach is warranted or we can tolerate a variety of equal but different perspectives.

Over the past 30 years, there have been major expansions in publichealth insurance for low-income children in the United States through Medicaid, the Children's Health Insurance Program (CHIP), and other state-based efforts. In addition, many low-income parents have gained Medicaid coverage since 2014 under the Affordable Care Act. Most of the research to date on health insurance coverage among low-income populations has focused on its effect on health care utilization and health outcomes, with much less attention to the financial protection it offers families. We review a growing body of evidence that publichealth insurance provides important financial benefits to low-income families. Expansions in publichealth insurance for low-income children and adults are associated with reduced out of pocket medical spending, increased financial stability, and improved material well-being for families. We also review the potential poverty-reducing effects of publichealth insurance coverage. When out of pocket medical expenses are taken into account in defining the poverty rate, Medicaid plays a significant role in decreasing poverty for many children and families. In addition, publichealth insurance programs connect families to other social supports such as food assistance programs that also help reduce poverty. We conclude by reviewing emerging evidence that access to publichealth insurance in childhood has long-term effects for health and economic outcomes in adulthood. Exposure to Medicaid and CHIP during childhood has been linked to decreased mortality and fewer chronic health conditions, better educational attainment, and less reliance on government support later in life. In sum, the nation's publichealth insurance programs have many important short- and long-term poverty-reducing benefits for low-income families with children.

Over the last thirty years, there have been major expansions in publichealth insurance for low-income children in the U.S. through Medicaid, the Children’s Health Insurance Program (CHIP), and other state-based efforts. In addition, many low-income parents have gained Medicaid coverage since 2014 under the Affordable Care Act. Most of the research to date on health insurance coverage among low-income populations has focused on its impact on health care utilization and health outcomes, with much less attention to the financial protection it offers families. We review a growing body of evidence that publichealth insurance provides important financial benefits to low-income families. Expansions in publichealth insurance for low-income children and adults are associated with reduced out-of-pocket medical spending, increased financial stability, and improved material well-being for families. We also review the potential poverty-reducing effects of publichealth insurance coverage. When out-of-pocket medical expenses are taken into account in defining the poverty rate, Medicaid plays a significant role in decreasing poverty for many children and families. In addition, publichealth insurance programs connect families to other social supports such as food assistance programs that also help reduce poverty. We conclude by reviewing emerging evidence that access to publichealth insurance in childhood has long-term effects for both health and economic outcomes in adulthood. Exposure to Medicaid and CHIP during childhood has been linked to decreased mortality and fewer chronic health conditions, better educational attainment, and less reliance on government support later in life. In sum, the nation’s publichealth insurance programs have many important short and long-term poverty-reducing benefits for low-income families with children. PMID:27044710

Community health educators are well versed in the behavior sciences, including intervention theories. However, most publichealth professionals are not familiar with the policy theories related to political advocacy. Because health educators are engaging in policy advocacy more frequently, and as a result of the profession including policy…

Context: Today's societies have far-reaching impacts on future conditions for health. Against this backdrop, this article explores how the future is represented in contemporary publichealth, examining both its conceptual base and influential approaches through which evidence is generated for policy. Methods: Mission statements and official reviews provide insight into how the future is represented in publichealth's conceptual and ethical foundations. For its research practices, the article takes examples from epidemiological, intervention, and economic research, selecting risk-factor epidemiology, randomized controlled trials, and economic evaluation as exemplars. Findings: Concepts and ethics suggest that publichealth research and policy will be concerned with protecting both today's and tomorrow's populations from conditions that threaten their health. But rather than facilitating sustained engagement with future conditions and future health, exemplary approaches to gathering evidence focus on today's population. Thus, risk-factor epidemiology pinpoints risks in temporal proximity to the individual; controlled trials track short-term effects of interventions on the participants’ health; and economic evaluations weigh policies according to their value to the current population. While their orientation to the present and near future aligns well with the compressed timescales for policy delivery on which democratic governments tend to work, it makes it difficult for the publichealth community to direct attention to conditions for future health. Conclusions: This article points to the need for research perspectives and practices that, consistent with publichealth's conceptual and ethical foundations, represent the interests of both tomorrow's and today's populations. PMID:20579281

The publichealth community has traditionally paid little attention to the health needs of people with disabilities. Recent activities, however, on the part of federal and international organizations mark a shift toward engaging the health concerns of this large and growing population. First, the World Health Organization published the International Classification of Functioning, Disability, and Health (ICF), a companion to the International Classification of Diseases. The ICF describes both a conceptual framework and a classification system, providing the foundation for publichealth science and policy. Second, a vision for the future of publichealth and disability is outlined in Healthy People 2010 that, for the first time, includes people with disabilities as a targeted population. The article briefly describes activities and emerging opportunities for a publichealth focus on people with disabilities with the ICF as a foundation and Healthy People 2010 as a vision. Publichealth has traditionally responded to emerging needs; people with disabilities are a group whose health needs should be targeted.

Climate change is a major challenge facing publichealth. National governments play a key role in publichealth adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine how national-level publichealth adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in publichealth adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation—cross-sectoral collaboration, vertical coordination and national health adaptation planning—and identify practical examples suited to different contexts. We systematically reviewed publicly available publichealth adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to publichealth adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their publichealth adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning. PMID:27618074

Climate change is a major challenge facing publichealth. National governments play a key role in publichealth adaptation to climate change, but there are competing views on what responsibilities and obligations this will-or should-include in different nations. This study aims to: (1) examine how national-level publichealth adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in publichealth adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation-cross-sectoral collaboration, vertical coordination and national health adaptation planning-and identify practical examples suited to different contexts. We systematically reviewed publicly available publichealth adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to publichealth adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their publichealth adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning.

One widely held view of prenatal screening (PNS) is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: PublicHealth Pluralism. It is argued that there are good reasons to prefer the latter, including the following. (1) PublicHealth Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. (2) The Pure Choice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of PublicHealth Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) PublicHealth Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues. PMID:25521971

The University of New Mexico School of Medicine (UNMSOM) sought to train medical students in publichealth concepts, knowledge, and skills as a means of improving the health of communities statewide. Faculty members from every UNMSOM department collaborated to create and integrate a publichealth focus into all years of the medical school curriculum. They identified key competencies and developed new courses that would synchronize students' learning publichealth subjects with the mainstream medical school content. New courses include: Health Equity: Principles of PublicHealth; Epidemiology and Biostatistics; Evidence-Based Practice; Community-Based Service Learning; and Ethics in PublicHealth. Students experiencing the new courses, first in pilot and then final forms, gave high quantitative ratings to all courses. Some students' qualitative comments suggest that the PublicHealth Certificate has had a profound transformative effect. Instituting the integrated PublicHealth Certificate at UNMSOM places it among the first medical schools to require all its medical students to complete medical school with publichealth training. The new UNMSOM PublicHealth Certificate courses reunite medicine and publichealth in a unified curriculum.

Health protection legislation has been updated through amendments to the PublicHealth (Control of Disease) Act 1984 to take account of emerging diseases and the risk of contamination by adopting an all hazard approach to disease protection. To further strengthen safeguards for protecting health, new health protection powers have been given to local authorities and magistrates. The powers can be used to prevent and control the spread of infectious diseases and contamination. Health professionals, including district nurses, need to be aware of the health protection powers. This will enable them to take appropriate decisions in cases where voluntary measures to protect health are not possible.

This article describes how the CS2day (Cease Smoking Today) initiative positioned continuing education (CE) in the intersection between medicine and publichealth. The authors suggest that most CE activities address the medical challenges that clinicians confront, often to the neglect of the publichealth issues that are key risk factors for the…

Planning, organizing, and operating today's complex health care systems or heading Federal, State, and city publichealth agencies in the United States and other countries require professionals broadly prepared in the meaning, philosophy, and strategies of publichealth. It is and has been recognized that the best trained clinical physician could not be expected to know the policies and practices of official publichealth programs. The chief health official of a State or other jurisdiction, for example, deals with the epidemiology of many diseases; with all aspects of the environment; with hospitals, drugs, health manpower, and nutrition; with issues of health economics, finance, and politics; and with administration. For these tasks, most of medical education is irrelevant. To produce the needed specialists, candidates with a BA degree would be educated as doctors of publichealth. The proposed 5-year postgraduate curriculum is as demanding as the training for the MD degree, but completely different. The 38 subjects or courses in the curriculum are grouped into four categories: basic tools of social analysis, health and disease in populations, protection of health and prevention of disease, and health care systems and management. At present, MPH degree holders take only a handful of core and elective courses and emerge with little systematic knowledge about the majority of problems they face. The DrPH candidates at schools of publichealth spend most of their time on research and dissertation writing--adequate preparation for university teachers, but academia is not the goal of most candidates, nor the greatest need of society. Recruits for the proposed new doctorate in publichealth may be found among the thousands of young people who want to do "community health work" but see no way to play a significant role without getting an MD degree first.

The relationship between insurance and publichealth is an enduring topic in publichealth policy and practice. Insurers share certain attributes with publichealth. But publichealth agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and publichealth become particularly evident during periods of publichealth emergency, when a publichealth agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, publichealth agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the publichealth system. Critical issues of state and federal policy arise in the context of the publichealth/insurance relations during publichealth emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of publichealth emergency response.

Advances in laboratory and information technologies are transforming publichealth microbiology. High-throughput genome sequencing and bioinformatics are enhancing our ability to investigate and control outbreaks, detect emerging infectious diseases, develop vaccines, and combat antimicrobial resistance, all with increased accuracy, timeliness, and efficiency. The Advanced Molecular Detection (AMD) initiative has allowed the Centers for Disease Control and Prevention (CDC) to provide leadership and coordination in integrating new technologies into routine practice throughout the U.S. publichealth laboratory system. Collaboration and partnerships are the key to navigating this transition and to leveraging the next generation of methods and tools most effectively for publichealth.

Reviews what current research says about the holistic health benefits of park and recreation services, focusing on: health benefits according to park users; physical activities in parks; stress reduction benefits of park use; social support, self-determination, and stress reduction; observing nature in parks and associated benefits; and the…

As of the mid-19th century, most infectious disease epidemics have been fought and slowed down by taking action on the environment (water, housing, waste) and education. This constitutes the 1st publichealth revolution paradigm. As we face the current epidemic of chronic diseases and the failure of the dominant biomedical model to stop them, a 2nd publichealth revolution is needed. The vision for this 2nd publichealth revolution requires a new paradigm built upon an eco-systemic definition of health and the recognition of the legitimacy for citizen participation based on the precautionary principle.

Although climate change is a global concern, there are particular considerations for Indonesia as an archipelagic nation. These include the vulnerability of people living in small islands and coastal areas to rising sea levels; the expansion of the important mosquito-borne diseases, particularly malaria and dengue, into areas that lack of immunity; and the increase in water-borne diseases and malnutrition. This article proposes a set of publichealth responses to climate change health impacts in Indonesia. Some important principles and practices in publichealth are highlighted, to develop effective publichealth approaches to climate change in Indonesia.

Recent decades have been marked by the explosive development of innovative scientific, technological and business products and processes. Despite their immense impact on health globally, little has been accomplished in the field of global publichealth to incorporate, address and harness such innovations in practice. In order to meet the world's growing health needs, it is essential that global publichealth accepts and adapts to these innovations. Moreover, such innovations must be implemented equitably in ways that will best serve their intended recipients, without deepening health- and access-related disparities. This article will briefly discuss the wide array of technologies in the pipeline that will affect global publichealth practice, their impact on the field and on populations and the issues facing the field in adopting these innovations.

The Oregon PublicHealth Policy Institute (PHPI) was designed to enhance publichealth policy competencies among state and local health department staff. The Oregon Health Authority funded the College of PublicHealth and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state publichealth programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in publichealth policy competencies and high satisfaction with PHPI overall.

The scope of this paper is to describe characteristics of the scientific output in the area of public oral health in journals on publichealth and dentistry nationwide. The Scopus database of abstracts and quotations was used and eight journals in publichealth, as well as ten in dentistry, dating from 1947 to 2011 were selected. A research strategy using key words regarding oral health in publichealth and key words about publichealth in dentistry was used to locate articles. The themes selected were based on the frequency of key words. Of the total number of articles, 4.7% (n = 642) were found in oral health journals and 6.8% (n = 245) in publichealth journals. Among the authors who published most, only 12% published in both fields. There was a percentile growth of public oral healthpublications in dentistry journals, though not in publichealth journals. In dentistry, only studies indexed as being on the topic of epidemiology showed an increase. In the area of publichealth, planning was predominant in all the phases studied. Research to evaluate the impact of research and postgraduate policies in scientific production is required.

The article analyses the position of human health in the system of social economic relationships. The notion of material and technical resources in health institutions is defined. It is demonstrated that they are characterized by number of health institutions, their structure according levels and stages of medical care provision, costs of fixed assets, their structure and wear. The conceptual characteristics of actual management of publichealth resources are analyzed.

Global publichealth is increasingly being seen as a speciality field within the university education of publichealth. However, the exact meaning of global publichealth is still unclear, resulting in varied curricula and teaching units among universities. The contextual differences between high- and low- and middle-income countries, and the process of globalization need to be taken into account while developing any global publichealth course. Global publichealth and publichealth are not separable and global publichealth often appears as an extension of publichealth in the era of globalization and interdependence. Though global publichealth is readily understood as health of global population, it is mainly practiced as health problems and their solutions set within low- and middle-income countries. Additional specialist competencies relevant to the context of low- and middle-income countries are needed to work in this field. Although there can be a long list of competencies relevant to this broad topic, available literature suggests that knowledge and skills related with ethics and vulnerable groups/issues; globalization and its impact on health; disease burden; culture, society, and politics; and management are important. PMID:26191520

Although publichealth in Canada faces concerns similar to those noted by Tilson and Berkowitz in the US, a review we conducted of how publichealth is financed and delivered in Canada also highlights some key differences. In both systems, publichealth labours under similar disadvantages: it is invisible when it succeeds; it has overtones of a "nanny state" and it focuses on often unpopular vulnerable populations. Prevention is always at risk of being raided to finance treatment. Yet, Canada, because there are fewer financial barriers to receiving medically necessary personal services, can focus more attention on what Tilson and Berkowitz term "the ecology of health." We highlight some of the strengths and ongoing challenges of the Canadian publichealth system. We conclude that the issue appears less the need to measure performance, than the recognition that one size does not fit all. In particular, for threats to publichealth that transcend borders, local failure can affect wider populations and suggests a need to look beyond local, provincial or national sovereignty. Publichealth is heterogeneous, and many roads may lead us to the promised land.

Swift is a satellite equipped with γ-ray, X-ray, and optical-UV instruments aimed at discovering, localizing, and collecting data from gamma-ray bursts (GRBs). Launched at the end of 2004, this small-size mission finds about a hundred GRBs per year, totaling more than 700 events as of 2012. In addition to GRBs, Swift observes other energetic events, such as active galactic nuclei (AGNs), novae, and supernovae. Here we look at its success using bibliometric tools; that is, the number of papers using Swift data and their impact (i.e., number of citations to those papers). We derived these from the publication years 2005 to 2011, and compared them with the same numbers for other major observatories. Swift provided data for 1101 papers in the interval 2005–2011, with 24 in the first year, to 287 in the last year. In 2011, Swift had more than double the number of publications as Subaru, it overcame Gemini by a large fraction, and reached Keck. It is getting closer to the ∼400 publications of the successful high-energy missions XMM-Newton and Chandra, but is still far from the most productive telescopes, VLT (over 500) and HST (almost 800). The overall average number of citations per paper, as of 2012 November, is 28.3, which is comparable to the others, but lower than Keck (41.8). The science topics covered by Swift publications have changed from the first year, when over 80% of the papers were about GRBs, falling to less than 30% in 2011.

Publichealth agencies at state and local levels are integrating information systems to improve health outcomes for children. An assessment was conducted to describe the extent to which publichealth agencies are currently integrating child health information systems (CHIS). Using online technology information was collected, to assess completed and planned activities related to integration of CHIS, maturity of these systems, and factors that influence decisions by publichealth agencies to pursue integration activities. Of the 39 publichealth agencies that participated, 18 (46%) reported already integrating some or all of their CHIS, and 13 (33%) reported to be planning to integrate during the next 3 years. Information systems most commonly integrated include Early Hearing Detection and Intervention (EHDI), immunization, vital records, and Newborn Dried Bloodspot Screening (NDBS). Given the high priority that has been placed on using technology to improve health status in the United States, the emphasis on expanding the capability for the electronic exchange of health information, and federal support for electronic health records by 2014, publichealth agencies should be encouraged and supported in their efforts to develop, implement, and maintain integrated CHIS to facilitate the electronic exchange of health information with the clinical healthcare sector.

Publichealth communication aims to influence health practices of large populations, including maternal health care providers (traditional birth attendants, (TBAs), nurse-midwives, other indigenous practitioners, and physicians). A quality assurance process is needed to give public sector health providers feedback. Computerized record keeping is needing for quality assurance of maternal health programs. The Indian Rural Medical Association has trained more than 20,000 rural indigenous practitioners in West Bengal. Training of TBAs is expensive and rarely successful. However, trained health professional leading group discussions of TBAs is successful at teaching them about correct maternity care. Health education messages integrated into popular songs and drama is a way to reach large illiterate audiences. Even though a few donor agencies and governments provide time and technical assistance to take advantage of the mass media as a means to communicate health messages, the private sector has most of the potential. Commercial advertisements pay for Video on Wheels, which, with 100 medium-sized trucks each fitted with a 100-inch screen, plays movies for rural citizens of India. They are exposed to public and family planning messages. Jain Satellite Television (JST) broadcasts 24 hours a day and plans to broadcast programs on development, health and family planning, women's issues, and continuing education for all health care providers (physicians, nurses, TBAs, community workers, and indigenous practitioners). JST and the International Federation for Family Health plan to telecast courses as part of an Open University of Health Sciences.

Epidemiologists and environmental health researchers have a joint responsibility to acquire scientific knowledge that matters to publichealth and to apply the knowledge gained in publichealth practice. We examine the nature and source of these social responsibilities, discuss a debate in the epidemiological literature on roles and responsibilities, and cite approaches to environmental justice as reflective of them. At one level, responsibility refers to accountability, as in being responsible for actions taken. A deeper meaning of responsibility corresponds to commitment to the pursuit and achievement of a valued end. Epidemiologists are committed to the scientific study of health and disease in human populations and to the application of scientific knowledge to improve the public's health. Responsibility is also closely linked to reliability. Responsible professionals reliably perform the tasks they set for themselves as well as the tasks society expects them to undertake. The defining axiom for our approach is that the health of the public is a social good we commit ourselves to pursue, thus assuming an obligation to contribute to its achievement. Epidemiologists cannot claim to be committed to publichealth as a social good and not accept the responsibility of ensuring that the knowledge gained in their roles as scientists is used to achieve that good. The social responsibilities of environmental health researchers are conspicuous in the environmental justice movement, for example, in community-based participatory research. Responsibility is an ethical concept particularly well suited to frame many key aspects of the ethics of our profession. PMID:14602514

Epidemiologists and environmental health researchers have a joint responsibility to acquire scientific knowledge that matters to publichealth and to apply the knowledge gained in publichealth practice. We examine the nature and source of these social responsibilities, discuss a debate in the epidemiological literature on roles and responsibilities, and cite approaches to environmental justice as reflective of them. At one level, responsibility refers to accountability, as in being responsible for actions taken. A deeper meaning of responsibility corresponds to commitment to the pursuit and achievement of a valued end. Epidemiologists are committed to the scientific study of health and disease in human populations and to the application of scientific knowledge to improve the public's health. Responsibility is also closely linked to reliability. Responsible professionals reliably perform the tasks they set for themselves as well as the tasks society expects them to undertake. The defining axiom for our approach is that the health of the public is a social good we commit ourselves to pursue, thus assuming an obligation to contribute to its achievement. Epidemiologists cannot claim to be committed to publichealth as a social good and not accept the responsibility of ensuring that the knowledge gained in their roles as scientists is used to achieve that good. The social responsibilities of environmental health researchers are conspicuous in the environmental justice movement, for example, in community-based participatory research. Responsibility is an ethical concept particularly well suited to frame many key aspects of the ethics of our profession.

The transformation to managed care is one of the most important and complex changes ever to take place in the American health system. One key aspect of this transformation is its implications for publichealth policy and practice. Both public and private buyers purchase managed care; increasingly, public programs that used to act as their own insurers (i.e., Medicare, Medicaid and CHAMPUS) are purchasing large quantities of managed care insurance from private companies. The transformation to managed care is altering the manner in which publichealth policy makers conceive of and carry out publichealth activities (particularly activities that involve the provision of personal health services). The degree to which managed care changes publichealth and in turn is altered by publichealth will depend in great measure on the extent to which public and private policy makers understand the implications of their choices for various aspects of publichealth and take steps to address them. Because both publicly and privately managed care arrangements are relatively deregulated, much of the dialogue between publichealth and managed care purchasers can be expected to take place within the context of the large service agreements that are negotiated between buyers and sellers of managed care products. This is particularly true for Medicaid because of the importance of Medicaid coverage, payment and access policies to publichealth policy makers, and because of the public nature of the Medicaid contracting process. A nationwide study of Medicaid managed care contracts offers the first detailed analysis of the content and structure of managed care service agreements and the publichealth issues they raise. Four major findings emerge from a review of the contracts. First, most of the agreements fail to address key issues regarding which Medicaid-covered services and benefits are the contractor's responsibility and which remain the residual responsibility of the state agency

This article addresses illegal drug use within the current debate in traditional publichealth and in proposals from Latin America, while emphasizing the need to approach the issue from an alternative publichealth perspective centered on individual users, groups, and social movements as protagonists. This counterhegemonic approach thus aims to orient the discussion on the need for inclusive and democratic public policies. Illegal drug use has been addressed from various perspectives: clinical medicine, viewing it as a problem that generates mental disorders and infectious diseases, both through risky sexual practices and/or use of injecting paraphernalia; from a legal perspective, as a problem related to delinquency; and according to traditional publichealth, as a problem that generates school dropout and work absenteeism and increases the demand on health services, in addition to increasing violence and death. However, not all forms of drug consumption involve problematic use, nor do they all trigger disorders related to substance use.

An inquiry into options for Masters-level training and into attitudes and perceptions among a convenience sample of nutrition students and professionals from 11 countries suggests that the term, "PublicHealth Nutrition", as such, is poorly represented and poorly understood in the Latin American region. At least six countries (Brazil, Chile, Cuba, Mexico, Peru, Puerto Rico) at seven sites have Masters programs to provide training for nutrition in a publichealth context or publichealth with an emphasis in nutrition. Exploring alliances from the Americas with the formal PHN discipline emerging in Europe should enrich the mutual perspective on curriculum design. However, the form and context of postgraduate training in Latin America must consider first and foremost its own job-markets, diverse publichealth needs, and resource allocations in building or transforming training programs.

EPA and the Centers for Disease Control and Prevention (CDC) issued a joint statement on the publichealth impacts of bed bugs, which are blood-sucking ectoparasites (external parasites). EPA also has a pesticide registration notice on this topic.

The challenges posed by a globalised world have made it imperative for society to search for solutions to emerging issues and to develop new ways of looking at old problems. Current discussions about global publichealth demand a shift in paradigms and the strategic positioning of publichealth within broader policy discussions that will enable it to influence political and action agendas. Critical to responding to these challenges is the generation, transmission and dissemination of new knowledge to create value. Recognising the cutting-edge role of knowledge, as a new form of capital that drives innovation and transforms society, the formation of knowledge networks is viewed as a strategy for developing a shared intellectual, conceptual and ethical infrastructure for the field of global publichealth. These knowledge networks are envisioned as a vehicle for sharing diverse perspectives, encouraging debate and sustaining alternative ways of thinking about and responding to the challenges that confront global publichealth today and in the future.

PublicHealth 2016, the Canadian PublicHealth Association's annual conference, was held from June 13 to 16, 2016, in Toronto, Canada, and showcased a wide variety of publichealth issues that fostered considerable discussion at the conference and on social media. The four plenary sessions, while on seemingly disparate topics including technology, violence prevention, racism and harm reduction, all revealed the need for a cultural shift in the field of publichealth that acknowledges and addresses the broader inequities that influence the health and well-being of populations. They also highlighted some of the key challenges that society faces in achieving the UN Sustainable Development Goals released in 2015.

Federal, state, and local labor laws establish minimum standards for working conditions, including wages, work hours, occupational safety, and collective bargaining. The adoption and enforcement of labor laws protect and promote social, economic, and physical determinants of health, while incomplete compliance undermines these laws and contributes to health inequalities. Using existing legal authorities, some publichealth agencies may be able to contribute to the adoption, monitoring, and enforcement of labor laws. We describe how routine publichealth functions have been adapted in San Francisco, California, to support compliance with minimum wage and workers' compensation insurance standards. Based on these experiences, we consider the opportunities and obstacles for health agencies to defend and advance labor standards. Increasing coordinated action between health and labor agencies may be a promising approach to reducing health inequities and efficiently enforcing labor standards.

Federal, state, and local labor laws establish minimum standards for working conditions, including wages, work hours, occupational safety, and collective bargaining. The adoption and enforcement of labor laws protect and promote social, economic, and physical determinants of health, while incomplete compliance undermines these laws and contributes to health inequalities. Using existing legal authorities, some publichealth agencies may be able to contribute to the adoption, monitoring, and enforcement of labor laws. We describe how routine publichealth functions have been adapted in San Francisco, California, to support compliance with minimum wage and workers' compensation insurance standards. Based on these experiences, we consider the opportunities and obstacles for health agencies to defend and advance labor standards. Increasing coordinated action between health and labor agencies may be a promising approach to reducing health inequities and efficiently enforcing labor standards. PMID:24179278

To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against publichealth policies. Through advertising, covertly solicited media coverage, and contributions to legislators’ pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the publichealth field as grantees were converted to stakeholders. PMID:18923118

To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against publichealth policies. Through advertising, covertly solicited media coverage, and contributions to legislators' pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the publichealth field as grantees were converted to stakeholders.

Using a social-ecological framework, we drew on a targeted literature review and historical and contemporary cases from the US labor movement to illustrate how unions address physical and psychosocial conditions of work and the underlying inequalities and social determinants of health. We reviewed labor involvement in tobacco cessation, hypertension control, and asthma, limiting articles to those in English published in peer-reviewed publichealth or medical journals from 1970 to 2013. More rigorous research is needed on potential pathways from union membership to health outcomes and the facilitators of and barriers to union-publichealth collaboration. Despite occasional challenges, publichealth professionals should increase their efforts to engage with unions as critical partners.

Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of publichealth policy at low cost. Although incorporating insights from behavioral economics into publichealth policy has the potential to improve population health, its integration into government publichealth programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

Using a social–ecological framework, we drew on a targeted literature review and historical and contemporary cases from the US labor movement to illustrate how unions address physical and psychosocial conditions of work and the underlying inequalities and social determinants of health. We reviewed labor involvement in tobacco cessation, hypertension control, and asthma, limiting articles to those in English published in peer-reviewed publichealth or medical journals from 1970 to 2013. More rigorous research is needed on potential pathways from union membership to health outcomes and the facilitators of and barriers to union–publichealth collaboration. Despite occasional challenges, publichealth professionals should increase their efforts to engage with unions as critical partners. PMID:25521905

The Institute of Medicine has stated that legal structures and the authority vested in health agencies and other partners within the publichealth system are essential to improving the public's health. Variation between the laws of different jurisdictions within the United States allows for natural experimentation and research into their…

According to many experts, a publichealth emergency arising from an influenza pandemic, bioterrorism attack, or natural disaster is likely to develop in the next few years. Meeting the publichealth and medical response needs created by such an emergency will likely involve volunteers, health care professionals, public and private hospitals and clinics, vaccine manufacturers, governmental authorities, and many others. Conducting response activities in emergency circumstances may give rise to numerous issues of liability, and medical professionals and other potential responders have expressed concern about liability exposure. Providers may face inadequate resources, an insufficient number of qualified personnel, overwhelming demand for services, and other barriers to providing optimal treatment, which could lead to injury or even death in some cases. This article describes the different theories of liability that may be used by plaintiffs and the sources of immunity that are available to publichealth emergency responders in the public sector, private sector, and as volunteers. It synthesizes the existing immunity landscape and analyzes its gaps. Finally, the authors suggest consideration of the option of a comprehensive immunity provision that addresses liability protection for all health care providers during publichealth emergencies and that, consequently, assists in improving community emergency response efforts.

Supporters of eugenics, the powerful early 20th-century movement for improving human heredity, often attacked that era's dramatic improvements in publichealth and medicine for preserving the lives of people they considered hereditarily unfit. Eugenics and publichealth also battled over whether heredity played a significant role in infectious diseases. However, American publichealth and eugenics had much in common as well. Eugenic methods often were modeled on the infection control techniques of publichealth. The goals, values, and concepts of disease of these two movements also often overlapped. This paper sketches some of the key similarities and differences between eugenics and publichealth in the United States, and it examines how their relationship was shaped by the interaction of science and culture. The results demonstrate that eugenics was not an isolated movement whose significance is confined to the histories of genetics and pseudoscience, but was instead an important and cautionary part of past publichealth and a general medical history as well. PMID:9366633

The Constitution of the World Health Organization (1946) states that the "enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social position." The international legal framework for this right was laid by the Universal Declaration of Human Rights (1948) and reaffirmed in the International Covenant on Economic, Social, and Cultural Rights (1966) and the Declaration of Alma-Ata (1978). In recent years, the framework has been developed on 10 key elements: national and international human rights, laws, norms, and standards; resource constraints and progressive realization; obligations of immediate effect; freedoms and entitlements; available, accessible, acceptable, and good quality; respect, protect, and fulfill; non-discrimination, equality, and vulnerability; active and informed participation; international assistance and cooperation; and monitoring and accountability. Whereas publichealth law plays an essential role in the protection and promotion of the right to health, the emergence of SARS (2003) highlighted the urgent need to reform national publichealth laws and international obligations relating to publichealth in order to meet the new realities of a globalized world, leading to the WHO Framework Convention on Tobacco Control (2003) and the revision of the WHO International Health Regulations (2005). The Asian Institute for Bioethics and Health Law, in conjunction with the Republic of Korea's Ministry of Health and Welfare and the WHO International Digest of Health Legislation, conducted a comparative legal analysis of national publichealth laws in various countries through a project entitled Domestic Profiles of Public/Population Health Legislation (2006), which underscored the importance of recognizing the political and social contexts of distinct legal cultures, including Western, Asian, Islamic, and African.

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer deaths worldwide, primarily affecting populations in the developing countries. Aflatoxin, a food contaminant produced by the fungi Aspergillus flavus and Aspergillus parasiticus, is a known human carcinogen that has been shown to be a causative agent in the pathogenesis of HCC. Aflatoxin can affect a wide range of food commodities including corns, oilseeds, spices, and tree nuts as well as milk, meat, and dried fruit. Many factors affect the growth of Aspergillus fungi and the level of aflatoxin contamination in food. Drought stress is one of the factors that increase susceptibility of plants to Aspergillus and thus aflatoxin contamination. A recent drought is thought to be responsible for finding of trace amounts of aflatoxin in some of the corn harvested in the United States. Although it's too soon to know whether aflatoxin will be a significant problem, since United States is the world's largest corn producer and exporter, this has raised alarm bells. Strict regulations and testing of finished foods and feeds in the United States should prevent a majorhealth scare, and prevent human exposure to deleterious levels of aflatoxin. Unfortunately, such regulations and testing are not in place in many countries. The purpose of this editorial is to summarize the current knowledge on association of aflatoxin and HCC, encourage future research and draw attention to this global publichealth issue.

The connection between energy policy and increased levels of respiratory and cardiopulmonary disease has become clearer in the past few years. People living in cities with high levels of pollution have a higher risk of mortality than those living in less polluted cities. The pollutants most directly linked to increased morbidity and mortality include ozone, particulates, carbon monoxide, sulfur dioxide, volatile organic compounds, and oxides of nitrogen. Energy-related emissions generate the vast majority of these polluting chemicals. Technologies to prevent pollution in the transportation, manufacturing, building, and utility sectors can significantly reduce these emissions while reducing the energy bills of consumers and businesses. In short, clean energy technologies represent a very cost-effective investment in publichealth. Some 72% of the Federal government's investment in the research, development, and demonstration of pollution prevention technologies is made by the Department of Energy, with the largest share provided by the Office of Energy Efficiency and Renewable Energy. This article will examine the connections between air pollution and health problems and will discuss what the Department of Energy is doing to prevent air pollution now and in the future. Images p390-a p391-a p392-a p393-a p394-a p395-a p396-a p397-a PMID:8837627

Disinfection of drinking water through processes including filtration and chlorination was one of the major achievements of publichealth, beginning in the late 1800s and the early 1900s. Chloroform and other chlorination disinfection by-products (CBPs) in drinking water were first reported in 1974. Chloroform and several other CBPs are known to cause cancer in experimental animals, and there is growing epidemiologic evidence of a causal role for CBPs in human cancer, particularly for bladder cancer. It has been estimated that 14 16% of bladder cancers in Ontario may be attributable to drinking water containing relatively high levels of CBPs; the US Environmental Protection Agency has estimated the attributable risk to be 2 17%. These estimates are based on the assumption that the associations observed between bladder cancer and CBP exposure reflect a cause-effect relation. An expert working group (see Workshop Report in this issue) concluded that it was possible (60% of the group) to probable (40% of the group) that CBPs pose a significant cancer risk, particularly of bladder cancer. The group concluded that the risk of bladder and possibly other types of cancer is a moderately important publichealth problem. There is an urgent need to resolve this and to consider actions based on the body of evidence which, at a minimum, suggests that lowering of CBP levels would prevent a significant fraction of bladder cancers. In fact, given the widespread and prolonged exposure to CBPs and the epidemiologic evidence of associations with several cancer sites, future research may establish CBPs as the most important environmental carcinogens in terms of the number of attributable cancers per year.

Genetics research has shown enormous developments in recent decades, although as yet with only limited clinical application. Bioethical analysis has been unable to deal with the vast problems of genetics because emphasis has been put on the principlism applied to both clinical and research bioethics. Genetics nevertheless poses its most complex moral dilemmas at the public level, where a social brand of ethics ought to supersede the essentially interpersonal perspective of principlism. A more social understanding of ethics in genetics is required to unravel issues such as research and clinical explorations, ownership and patents, genetic manipulation, and allocation of resources. All these issues require reflection based on the requirements of citizenry, consideration of common assets, and definition of public policies in regulating genetic endeavors and protecting the society as a whole Bioethics has privileged the approach to individual ethical issues derived from genetic intervention, thereby neglecting the more salient aspects of genetics and social ethics.

Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the publichealth sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in publichealth and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing publichealth programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the publichealth sector in Ontario. Publichealth departments will need to capitalize on opportunities to integrate climate change into policies and programs

This article proposes the establishment of a prize fund to incentivise publichealth research within the BRICS association, which comprises the five major emerging world economies: Brazil, Russia, India, China and South Africa. This would stimulate cooperative healthcare research within the group and, on the proviso that the benefits of the research are made freely available within the association, would be rewarding for researchers. The results of the research stimulated by the prize would provide beneficial new healthcare technologies, targeting the most vulnerable and needy groups. The proposed fund is consistent with current international patent law and would not only avoid some of the problems associated with the "Health Impact Fund", but also create a new model for healthcare research.

Health disparities are a publichealth concern in Rhode Island and around the world. Faculty members and students in the Brown University School of PublicHealth are working to understand, address, and ultimately eliminate disparities in health and health care affecting diverse populations. Our educational offerings and research efforts are directed toward understanding and addressing the social, cultural, and environmental factors that contribute to these health disparities. Research methods to carry out this work include implementing interdisciplinary, community-based, quantitative and qualitative research with the goal of preventing, reducing, and eliminating health disparities. This article focuses on some of the School's work with vulnerable communities confronting issues around the following: HIV/AIDS, obesity, nutrition, physical activity and delivery of health services.

Career guidance may have the potential to promote publichealth by contributing positively to both the prevention of mental health conditions and to population level well-being. The policy implications of this possibility have received little attention. Career guidance agencies are well placed to reach key target groups. Producing persuasive…

Individuals with Acquired Immune Deficiency Syndrome (AIDS) or AIDS-related conditions (ARC) need continual care and support, at a level which can severely tax the health resources of a community. Publichealth nursing should have a central role in the effective and efficient response to this devastating problem. Since the early stages of the AIDS…

Sustainability remains a key challenge in publichealth. The perspective article by Fagen and Flay adds to our understanding of technical factors associated with sustaining health interventions in schools. In this commentary, the Fagen and Flay article (2009) is considered within the broader literature on sustainability. By taking a broad view,…

A survey of 20 publichealth schools and 240 university schools of nursing found that nuclear war related content was most likely to be appear in disaster nursing and in environmental health courses. Innovative curricula included political action projects for nuclear war prevention. (FMW)

Publichealth policy has arguably taken a new direction in the UK since 1997. This is typified by a review of the publichealth workforce. A key profession within this workforce is that of health visiting. Starting Well, a Scottish National Health Demonstration Project is one attempt to develop the publichealth role of health visitors. The project aimed to improve child health by providing intensive home visiting to families in Glasgow. This paper reports on a process study focused on whether Starting Well, an intervention exemplifying contemporary publichealth policy, could be operationalised through health visiting practice. Semi-structured interviews were conducted with a purposive sample of 44 staff responsible for developing and implementing the programme. Whilst greater contact with families allowed health visitors to develop their understanding of the life circumstances of their case-load families, the evaluation raised issues about the feasibility of systematically changing practice and demonstrated the difficulties of implementing an approach that relied as much on individual values and organisational context as formal guidelines and standardised tools. Furthermore, the ability of the systems and structures within which practitioners were operating to facilitate a broad publichealth approach was limited. The policy context for publichealth demands that increasing numbers of health workers are familiar with its principles and modus operandi. It remains, however, a contested area of work and its implementation requires change at a number of levels. This has implications for current policy assumptions about improving population health.

Graduate students and postdoctoral fellows—including those at the Harvard School of PublicHealth (HSPH)—have somewhat limited opportunities outside of traditional coursework to learn holistically about publichealth. Because this lack of familiarity could be a barrier to fruitful collaboration across disciplines, HSPH postdocs sought to address this challenge. In response, the PublicHealth 101 Nanocourse was developed to provide an overview of five core areas of publichealth (biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavioral sciences) in a two half-day course format. We present our experiences with developing and launching this novel approach to acquainting wider multidisciplinary audiences with the field of publichealth. PMID:25706019

Graduate students and postdoctoral fellows-including those at the Harvard School of PublicHealth (HSPH)-have somewhat limited opportunities outside of traditional coursework to learn holistically about publichealth. Because this lack of familiarity could be a barrier to fruitful collaboration across disciplines, HSPH postdocs sought to address this challenge. In response, the PublicHealth 101 Nanocourse was developed to provide an overview of five core areas of publichealth (biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavioral sciences) in a two half-day course format. We present our experiences with developing and launching this novel approach to acquainting wider multidisciplinary audiences with the field of publichealth.

Alterations in coastal ecology are expanding the geographic extent, frequency, magnitude, and species complexity'' of algal blooms throughout the world, increasing the threat of fish and shellfish poisonings, anoxia in marine nurseries, and of cholera. The World Health Organization and members of the medical profession have described the potential health effects of global climate change. They warn of the consequences of increased ultraviolet-B (UV-B) rays and of warming: the possible damage to agriculture and nutrition, and the impact on habitats which may alter the distribution of vector-borne and water-based infectious diseases. Algal growth due to increased nitrogen (N) and phosphorus (P) and warming are already affecting marine microflora and aquatic plants; and there is now clear evidence that marine organisms are a reservoir for enteric pathogens. The pattern of cholera in the Western Hemisphere suggests that environmental changes have already begun to influence the epidemiology of this infectious disease. 106 refs.

Swedish publichealth policy clearly illustrates how the concept of the Ottawa Charter for health promotion can be utilized at a national level. The impact has been more implicit than explicit. Publichealth has a long history in Sweden and much of the present and future is, and will be, linked to traditional values and structures. International input, however, has been essential to prompt new approaches and change. Health inequalities remain the major shortcoming. The Swedish system offers universal access to healthcare in a decentralized system. Still, primary healthcare, and the health services as a whole have not yet sufficiently embraced the idea of health promotion. Political attention to modern publichealth at the Prime Minister level was established in late 1980s. Since, continuous initiatives in terms of organization, infrastructure and funding have taken place. With regard to funding, a vast majority of the resources allocated to health promotion will be found outside the health sector. An interesting observation is that the Swedish publichealth policy with its 11 objective domains remains the same, also after a change of government. Future challenges include maintaining and developing an intersectoral mechanism for implementation, allocating more resources for intervention research to strengthen knowledge-based health promotion, and developing tools for coping better with the challenges of globalisation identified in the Bangkok Charter.

In Macedonia a band of devoted, associated physicians fought the plagues of the nearer Orient, a splendid example of cosmopolitan coöperation. Here is the story as viewed by American eyes of a work which is fundemental in the removal of a very serious menace to the health of the world. Imagesp15-ap15-bp16-ap17-ap17-bp18-ap19-ap20-a PMID:18010227

Fluoridation in Israel was first mooted in 1973 and finally incorporated into law in November 2002 obligating the Ministry of Health to add fluoride to the nation's water supply. Epidemiology studies in the USA have shown that the addition of one part per million of fluoride to the drinking water reduced the caries rate of children's teeth by 50% to 60% with no side effects. Both the WHO in 1994 and the American Surgeon General's report of 2000 declared that fluoridation of drinking water was the safest and most efficient way of preventing dental caries in all age groups and populations. Opposition to fluoridation has arisen from "antifluoridation" groups who object to the "pollution" of drinking water by the addition of chemicals and mass medication in violation of the "Patient's Rights" law and the Basic Law of Human Dignity and Liberty. A higher prevalence of hip fractures in elderly osteoporotic women and osteosarcoma in teenagers has been reported in areas where excess fluoride exists in the drinking water. However, none of the many independent professional committees reviewing the negative aspects of fluoridation have found any scientific evidence associating fluoridation with any ill-effects or health problems. In Israel, where dental treatment is not included in the basket of Health Services, fluoridation is the most efficient and cheapest way of reducing dental disease, especially for the poorer members of the population.

HELIX-Atlanta was developed to support current and future state and local EPHT programs to implement data linking demonstratio'n projects which could be part of the EPHT Network. HELIX-Atlanta is a pilot linking project in Atlanta for CDC to learn about the challenges the states will encounter. NASA/MSFC and the CDC are partners in linking environmental and health data to enhance publichealth surveillance. The use of NASA technology creates value - added geospatial products from existing environmental data sources to facilitate publichealth linkages. Proving the feasibility of the approach is the main objective

The innovative practice that resulted from the Ottawa Charter challenges publichealth knowledge about programming and evaluation. Specifically, there is a need to formulate program theory that embraces social determinants of health and local actors’ mobilization for social change. Likewise, it is imperative to develop a theory of evaluation that fosters reflexive understanding of publichealth programs engaged in social change. We believe advances in contemporary social theory that are founded on a critique of modernity and that articulate a coherent theory of practice should be considered when addressing these critical challenges. PMID:15798114

Background Experience with public engagement activities regarding the risks and benefits of science and technology (S&T) is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. Methods This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. Results The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. Conclusion Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues. PMID:18492256

Long-term objectives associated with cancer survivors have been suggested by Healthy People 2020, including increasing the proportion of survivors living beyond 5 years after diagnosis and improving survivors’ mental and physical health-related quality of life. Prior to reaching these objectives, several intermediate steps must be taken to improve the physical, social, emotional, and financial well-being of cancer survivors. Publichealth has a role in developing strategic, actionable, and measurable approaches to facilitate change at multiple levels to improve the lives of survivors and their families. The social ecological model has been used by the publichealth community as the foundation of multilevel intervention design and implementation, encouraging researchers and practitioners to explore methods that promote internal and external changes at the individual, interpersonal, organizational, community, and policy levels. The survivorship community, including publichealth professionals, providers, policymakers, survivors, advocates, and caregivers, must work collaboratively to identify, develop, and implement interventions that benefit cancer survivors. The National Action Plan for Cancer Survivorship highlights publichealth domains and associated strategies that can be the impetus for collaboration between and among the levels in the social ecological model and are integral to improving survivor outcomes. This paper describes the PublicHealth Action Model for Cancer Survivorship, an integrative framework that combines the National Action Plan for Cancer Survivorship with the social ecological model to demonstrate how interaction among the various levels may promote better outcomes for survivors. PMID:26590641

Inter-organizational networks represent one of the most promising practice-based approaches in publichealth as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically publichealth networks (n = 162), to better understand the structured relationships and interactions among publichealth organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of publichealth collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen publichealth practice partnerships. PMID:26445053

Asthma is a very common chronic disease that occurs in all age groups and is the focus of various clinical and publichealth interventions. Both morbidity and mortality from asthma are significant. The number of disability-adjusted life years (DALYs) lost due to asthma worldwide is similar to that for diabetes, liver cirrhosis and schizophrenia. Asthma management plans have, however, reduced mortality and severity in countries where they have been applied. Several barriers reduce the availability, affordability, dissemination and efficacy of optimal asthma management plans in both developed and developing countries. The workplace environment contributes significantly to the general burden of asthma. Patients with occupational asthma have higher rates of hospitalization and mortality than healthy workers. The surveillance of asthma as part of a global WHO programme is essential. The economic cost of asthma is considerable both in terms of direct medical costs (such as hospital admissions and the cost of pharmaceuticals) and indirect medical costs (such as time lost from work and premature death). Direct costs are significant in most countries. In order to reduce costs and improve quality of care, employers and health plans are exploring more precisely targeted ways of controlling rapidly rising health costs. Poor control of asthma symptoms is a major issue that can result in adverse clinical and economic outcomes. A model of asthma costs is needed to aid attempts to reduce them while permitting optimal management of the disease. This paper presents a discussion of the burden of asthma and its socioeconomic implications and proposes a model to predict the costs incurred by the disease. PMID:16175830

This review defines crisis risk communication, traces its origins to a number of applied fields, and then shows how basic principles have become incorporated into emergency preparedness and risk communication for publichealth. Literature from four different disciplines that inform crisis risk communications are reviewed. These are (a) environmental risk communication, (b) disaster management, (c) health promotion and communication, and (d) media and communication studies. Current curricula and training materials are briefly reviewed. Although this literature review suggests much progress has been made to incorporate and disseminate crisis risk communication principles into publichealth practice, and case studies suggest that publichealth workers have gained skills and experience, this emerging field still lacks in-depth evaluation of the effectiveness of event-specific crisis risk communication efforts.

Politics, for better or worse, plays a critical role in health affairs. The purpose of this article is to articulate a role for political analysis of publichealth issues, ranging from injury and disease prevention to health care reform. It begins by examining how health problems make it onto the policy agenda. Perceptions regarding the severity of the problem, responsibility for the problem, and affected populations all influence governmental responses. Next, it considers how bounded rationality, fragmented political institutions, resistance from concentrated interests, and fiscal constraints usually lead political leaders to adopt incremental policy changes rather than comprehensive reforms even when faced with serious publichealth problems. It then identifies conditions under which larger-scale transformation of health policy can occur, focusing on critical junctures in policy development and the role of policy entrepreneurs in seizing opportunities for innovation. Finally, it reviews the challenges confronting officials and agencies who are responsible for implementing and administering health policies. Publichealth professionals who understand the political dimensions of health policy can conduct more realistic research and evaluation, better anticipate opportunities as well as constraints on governmental action, and design more effective policies and programs.

Veterinary oncology has seen tremendous growth since the first textbook devoted to the subject in the late 1970s. Cancer is usually at the top of the list when owners ask about health concerns for their pets (and it remains the leading cause of death among dogs and cats). The volume, Veterinary Oncology Secrets, joins others in the series by presenting in question and answer format the type of information so important to veterinary students, interns and residents, general practitioners, and specialists in a number of clinical fields.

The field of health promotion has arguably shifted over the past thirty years from being socially proactive to biomedically defensive. In many countries this has been accompanied by a gradual decline, or in some cases the almost complete removal of health promotion designated positions within Government health departments. The language or discourse used to describe the practice and discipline of health promotion is reflective of such changes. In this study, critical discourse analysis was used to determine the representation of health promotion as a practice and a discipline within 10 Australian Government weight-related publichealth initiatives. The analysis revealed the invisibilization of critical health promotion in favour of an agenda described as 'preventive health'. This was achieved primarily through the textual practices of overlexicalization and lexical suppression. Excluding document titles, there were 437 uses of the terms health promotion, illness prevention, disease prevention, preventive health, preventative health in the documents analysed. The term 'health promotion' was used sparingly (16% of total terms), and in many instances was coupled with the term 'illness prevention'. Conversely, the terms 'preventive health' and 'preventative health' were used extensively, and primarily used alone. The progressive invisibilization of critical health promotion has implications for the perceptions and practice of those identifying as health promotion professionals and for people with whom we work to address the social and structural determinants of health and wellbeing. Language matters, and the language and intent of critical health promotion will struggle to survive if its speakers are professionally unidentifiable or invisible.

Soils sustain life. They affect human health via quantity, quality, and safety of available food and water, and via direct exposure of individuals to soils. Throughout the history of civilization, soil-health relationships have inspired spiritual movements, philosophical systems, cultural exchanges, and interdisciplinary interactions, and provided medicinal substances of paramount impact. Given the climate, resource, and population pressures, understanding and managing the soil-health interactions becomes a modern imperative. We are witnessing a paradigm shift from recognizing and yet disregarding the 'soil-health' nexus complexity to parameterizing this complexity and identifying reliable controls. This becomes possible with the advent of modern research tools as a source of 'big data' on multivariate nonlinear soil systems and the multiplicity of health metrics. The phenomenon of suppression of human pathogens in soils and plants presents a recent example of these developments. Evidence is growing about the dependence of pathogen suppression on the soil microbial community structure which, in turn, is affected by the soil-plant system management. Soil eutrophication appears to create favorable conditions for pathogen survival. Another example of promising information-rich research considers links and feedbacks between the soil microbial community structure and structure of soil physical pore space. The two structures are intertwined and involved in the intricate self-organization that controls soil services to publichealth. This, in particular, affects functioning of soils as a powerful water filter and the capacity of this filter with respect to emerging contaminants in both 'green' and 'blue' waters. To evaluate effects of soil services to publichealth, upscaling procedures are needed for relating the fine-scale mechanistic knowledge to available coarse-scale information on soil properties and management. More needs to be learned about health effects of soils

This article explores the functions of personal celebrity health narratives in the public sphere. This study examines data about 157 celebrities, including athletes, actors, musicians, and politicians, who have shared private information regarding a personal health situation (or that of a loved one) with others in the public domain. Part of a larger project on celebrity health narratives, this article highlights three key functions that celebrity health narratives perform--education, inspiration, and activism--and discusses the implications for celebrities and for public conversations about health-related issues.

Focusing mainly on the United States and Latin America, we aimed to identify the constructions of social reality held by the major stakeholders participating in policy debates about global trade, publichealth, and health services. In a multi-method, qualitative design, we used three sources of data: research and archival literature, 1980-2004; interviews with key informants who represented major organizations participating in these debates, 2002-2004; and organizational reports, 1980-2004. We targeted several types of organizations: government agencies, international financial institutions (IFIs) and trade organizations, international health organizations, multinational corporations, and advocacy groups. Many governments in Latin America define health as a right and health services as a public good. Thus, the government bears responsibility for that right. In contrast, the US government's philosophy of free trade and promoting a market economy assumes that by expanding the private sector, improved economic conditions will improve overall health with a minimum government provision of health care. US government agencies also view promotion of global health as a means to serve US interests. IFIs have emphasized reforms that include reduction and privatization of public sector services. International health organizations have tended to adopt the policy perspectives of IFIs and trade organizations. Advocacy groups have emphasized the deleterious effects of international trade agreements on publichealth and health services. Organizational stakeholders hold widely divergent constructions of reality regarding trade, publichealth, and health services. Social constructions concerning trade and health reflect broad ideologies concerning the impacts of market processes. Such constructions manifest features of "creed," regarding the role of the market in advancing human purposes and meeting human needs. Differences in constructions of trade and health constrain policies to

This analysis of national opinion polls shows that a majority of Americans support increased spending on publichealth in general and that they see publichealth interventions as saving money in the long term. At the same time, many do not favor increased federal spending in a number of areas that publichealth officials deem important. In addition, polls show striking partisan differences, with Republicans much less supportive than Democrats of additional spending on publichealth. This split may have political implications for the publichealth component of the new health reform law if there is a change in party control of one or more houses of Congress after the November 2010 elections. As a result, in order to sustain public support for increased spending, it will be critically important to give examples of cost savings from publichealth programs and to highlight how they have reduced mortality from major chronic illnesses, such as cancer, heart disease, and HIV/AIDS.

Purpose The aim of this paper is to describe the experience and educational benefits of a course that has several unique educational design features. Design/methodology/approach This includes narrative description of faculty and student experience from participants in a flipped-instructional-design inter-professional education course. Findings "Improving PublicHealth - An Interprofessional Approach to Designing and Implementing Effective Interventions" is an undergraduate publichealth course open to students regardless of background. Its student activities mirror the real-life tasks and challenges of working in a publichealth agency, including team-building and leadership; problem and project definition and prioritization; evidence-finding and critical appraisal; written and oral presentation; and press interviews. Students successfully developed project proposals to address real problems in a wide range of communities and settings and refined those proposals through interaction with professionals from population and publichealth, journalism and library sciences. Practical implications Undergraduate publichealth education is a relatively new endeavor, and experience with this new approach may be of value to other educators. Originality/value Students in this course, journalism graduate students who conducted mock interviews with them and instructors who oversaw the course all describe unique aspects and related personal benefit from this novel approach.

There is a growing body of literature and commentary analyzing the ethical and public policy concerns associated with xenotransplantation. While this technology holds great promise to provide an almost limitless supply of organs for transplantation, there remains grave concern about possible publichealth ramifications. As a result, it has been recommended that patients who undergo xenotransplantations will need to agree, inter alia, to a lifetime of close health monitoring, participation in an international database and autopsy upon death. It has been suggested that this agreement would transform the nature of informed consent into a "binding contract." Though such draconian measures are understandable given the magnitude of the risks involved, would existing common law and legislation allow their implementation? This paper analyzes relevant Canadian consent and publichealth law in the context of the xenotransplantation. Canada is a country with a particularly rich body of informed consent jurisprudence--jurisprudence firmly rooted (rightly or not) in the ethical principle of autonomy. In this climate, many of the suggested monitoring strategies would find little support from Canadian law. Before xenotransplantations proceed, policy makers must be sensitive to the legal barriers which exist to the implementation [of] effective publichealth measures. Effective surveillance programs will require novel approaches to consent and the enactment of specific publichealth laws.

The aim of this article is to highlight the importance of the history of publichealth for publichealth research and practice itself. After summarily reviewing the current great vitality of the history of collective health oriented initiatives, we explain three particular features of the historical vantage point in publichealth, namely the importance of the context, the relevance of a diachronic attitude and the critical perspective. In order to illustrate those three topics, we bring up examples taken from three centuries of fight against malaria, the so called "re-emerging diseases" and the 1918 influenza epidemic. The historical approach enriches our critical perception of the social effects of initiatives undertaken in the name of publichealth, shows the shortcomings of publichealth interventions based on single factors and asks for a wider time scope in the assessment of current problems. The use of a historical perspective to examine the plurality of determinants in any particular health condition will help to solve the longlasting debate on the primacy of individual versus population factors, which has been particularly intense in recent times. Keywords: history PMID:11511647

Governments use statutes, regulations, and policies, often in innovative ways, to promote health and safety. Organizations outside government, from private schools to major corporations, create rules on matters as diverse as tobacco use and paid sick leave. Very little of this activity is systematically tracked. Even as the rest of the health system is working to build, share, and use a wide range of health and social data, legal information largely remains trapped in text files and pdfs, excluded from the universe of usable data. This article makes the case for the practice of policy surveillance to help end the anomalous treatment of law in publichealth research and practice. Policy surveillance is the systematic, scientific collection and analysis of laws of publichealth significance. It meets several important needs. Scientific collection and coding of important laws and policies creates data suitable for use in rigorous evaluation studies. Policy surveillance addresses the chronic lack of readily accessible, nonpartisan information about status and trends in health legislation and policy. It provides the opportunity to build policy capacity in the publichealth workforce. We trace its emergence over the past fifty years, show its value, and identify major challenges ahead.

Law has played an important, but largely constitutive, role in the development of the publichealth enterprise. Thus, law has been central to setting up the institutions and offices of publichealth. The moral agenda has, however, been shaped to a much greater extent by bioethics. While social justice has been placed at the heart of this agenda, we argue that there has been little place within dominant conceptions of social justice for gender equity and women's interests which we see as crucial to a fully realised vision of social justice. We argue that, aside from particular interventions in the field of reproduction, publichealth practice tends to marginalise women-a claim we support by critically examining strategies to combat the HIV pandemic in sub-Saharan Africa. To counter the marginalisation of women's interests, this article argues that Amartya Sen's capabilities approach has much to contribute to the framing of publichealth law and policy. Sen's approach provides an evaluative and normative framework which recognises the importance of both gender and health equity to achieving social justice. We suggest that domestic law and international human rights provisions, in particular the emerging human right to health, offer mechanisms to promote capabilities, and foster a robust and inclusive conception of social justice.

Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article describes how corporate policies influence health and reviews recent health campaigns aimed at changing corporate behavior in six industries selected for their central role in the U.S. economy and their influence on major causes of mortality and morbidity. These are the alcohol, automobile, food, gun, pharmaceutical, and tobacco industries. The article defines corporate disease promotion and illustrates the range of publichealth activities that have emerged to counter such corporate behaviors. It analyzes the role of health professionals, government, and advocacy groups in these campaigns and assesses the implications of this domain for health education practice and research.

This review of the publichealth role of social marketing begins by tracing the history of social marketing and noting that social marketing adopts the traditional marketing framework of product, price, place, and promotion and embraces several methods of commercial marketing as well as consumer research. However, no universally acknowledged definition exists. A review of the literature is divided into three time periods representing early theoretical development, the evaluation of experiences, and increasing acceptance. Concerns about social marketing are discussed in terms of ethics, disempowerment, and the commercialization of health information. Examples of social marketing are then provided from developing countries and are analyzed in groupings defined as tangible products, sustained health practices, and service utilization. Practitioners' views and concerns are also reviewed. The strengths of social marketing include knowledge of the audience, systematic use of qualitative methods, use of incentives, closer monitoring, strategic use of the mass media, realistic expectations, aspiring to high standards, and recognition of price. Weaknesses of social marketing include its time, money, and human requirements; the fact that marketing elements are missing (publichealth lacks the flexibility to adjust products and services to clients' interests and preferences); and the potential serious impact on the future of Public Service Announcements, which may die out because social marketers pay for air time. After placing social marketing in context with other practices designed to achieve social change, the review ends with the prediction that the publichealth role of social marketing is likely to increase. The World Health Organization's recent call for health promotion and the UN Children's Fund's social mobilization actions are provided as examples of this increased role. It is noted, however, that social marketing alone cannot solve publichealth problems.

Disease surveillance has a century-long tradition in publichealth, and environmental data have been collected at a national level by the U.S. Environmental Protection Agency for several decades. Recently, the Centers for Disease Control and Prevention announced an initiative to develop a national environmental publichealth tracking (EPHT) network with "linkage" of existing environmental and chronic disease data as a central goal. On the basis of experience with long-established disease surveillance systems, in this article we suggest how a system capable of linking routinely collected disease and exposure data should be developed, but caution that formal linkage of data is not the only approach required for an effective EPHT program. The primary operational goal of EPHT has to be the "treatment" of the environment to prevent and/or reduce exposures and minimize population risk for developing chronic diseases. Chronic, multifactorial diseases do not lend themselves to data-driven evaluations of intervention strategies, time trends, exposure patterns, or identification of at-risk populations based only on routinely collected surveillance data. Thus, EPHT should be synonymous with a dynamic process requiring regular system updates to a) incorporate new technologies to improve population-level exposure and disease assessment, b) allow public dissemination of new data that become available, c) allow the policy community to address new and emerging exposures and disease "threads," and d) evaluate the effectiveness of EPHT over some appropriate time interval. It will be necessary to weigh the benefits of surveillance against its costs, but the major challenge will be to maintain support for this important new system. Key words: environmental health, evaluation, intervention, registries, surveillance.

Information Sharing System MOU Memorandum of Understanding NBIC National Biosurveillance Integration Center NCMI National Center for...definition, have come to the fore in the literature, biosurveillance and health security. Biosurveillance , as a term, is too limited to provide the...purposes. The Government Accountability Office (GAO) in a 2006 report on publichealth infrastructure described biosurveillance as, “…automated

Profiles are provided for innovative publichealth activities that focus on the health of children in day care. All are considered to be models worthy of replication. Profiles depict (1) child care in Arizona; (2) child day care licensing in Connecticut; (3) safeguarding children in day care in Kansas; (4) paired state and local inspection in…

The remit of publichealth is undergoing major transformation in the UK, and specialist community publichealth nurses are at the forefront of the changes. Much of their work will include child protection, which is the subject of this book.

The theories, phenomena, empirical findings, and methodological approaches that characterize contemporary social psychology hold much promise for addressing enduring problems in publichealth. Indeed, social psychologists played a major role in the development of the discipline of health psychology during the 1970s and 1980s. The health domain allows for the testing, refinement, and application of many interesting and important research questions in social psychology, and offers the discipline a chance to enhance its reach and visibility. Nevertheless, in a review of recent articles in two major social-psychological journals (Personality and Social Psychology Bulletin and Journal of Personality and Social Psychology), we found that only 3.2% of 467 studies explored health-related topics. In this article, we identify opportunities for research at the interface of social psychology and health, delineate barriers, and offer strategies that can address these barriers as the discipline continues to evolve.

Healthcare represents a key area in the public agenda. In the case of Chile, this central part of citizen demands has emerged with an increasing criticism of the health system, its actors and institutions, while a major democratic and legitimacy crisis in Chilean society unfolds. The starting point of this analysis is the link between the critical and widespread societal dissatisfaction with the legitimacy crisis in the health sector. There is an interdependence and parallelism between these two different aspects of the crisis. The analysis is built around the dimensions of trust and legitimacy as a potential driver of the conflict, taking as an analytical framework the socio-political matrix. Conceptual elements around the ideas of trust and legitimacy in public policies are reviewed. This article focuses on recent situations surrounding the dynamics of the Chilean health system such as the rise of the Instituciones de Salud Previsional (ISAPRE) and the market-driven health system, the failed health care reform of the last decade, conflicts of interest in the formulation of public policies, loss of legitimacy of healthcare authorities, and the role of the health professionals in this process. Finally, a discussion arises seeking to regain public trust as a central issue for the future development and sustainability of health policies.

On December 15, 2003, the Centers for PublicHealth Preparedness at the University of Minnesota and the University of Iowa convened the "PublicHealth and Terrorism Preparedness: Cross-Border Issues Roundtable." The purpose of the roundtable was to gather publichealth professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Representatives from six state and local publichealth departments and three provincial governments were invited to identify cross-border needs and issues using a nominal group process. The result of the roundtable was identification of the needs considered most important and most doable across all the focus groups. The need to collaborate on and exchange plans and protocols among agencies was identified as most important and most doable across all groups. Development of contact protocols and creation and maintenance of a contact database was also considered important and doable for a majority of groups. Other needs ranked important across the majority of groups included specific isolation and quarantine protocols for multi-state responses; a system for rapid and secure exchange of information; specific protocols for sharing human resources across borders, including emergency credentials for physicians and health care workers; and a specific protocol to coordinate Strategic National Stockpile mechanisms across border communities.

Mental health is a challenging publichealth issue worldwide and surveillance is crucial for it. However, mental health surveillance has not been developed until recently in certain developed countries; many other countries, especially developing countries, have poor or even no health information systems. This paper presents surveillance related to mental health in China, a developing country with a large population of patients with mental disorders. Detailed information of seven relevant surveillance systems is introduced respectively. From the perspective of utilization, problems including accessibility, comprehensiveness and data quality are discussed. Suggestions for future development are proposed.

Elevated concentrations of arsenic in groundwater pose a publichealth threat to millions of people worldwide, including severely affected populations in South and Southeast Asia. Although arsenic is an established human carcinogen and has been associated with a multitude of health outcomes in epidemiologic studies, a mode of action has yet to be determined for some aspects of arsenic toxicity. Herein, we emphasize the role of recent genetic and molecular epidemiologic investigations of arsenic toxicity. Additionally, we discuss considerations for the publichealth impacts of arsenic exposure through drinking water with respect to primary and secondary prevention efforts.

Created in the wake of the September 11, 2001 terrorist attacks, Maine's Office of PublicHealth Emergency Preparedness within the Maine Center for Disease Control and Prevention undertook a major reorganization of epidemiology and laboratory services and began developing relationships with key partners and stakeholders, and a knowledgeable and skilled publichealth emergency preparedness workforce. In 2003, these newly implemented initiatives were tested extensively during a mass arsenic poisoning at the Gustav Adolph Lutheran Church in the rural northern community of New Sweden, Maine. This episode serves as a prominent marker of how increased preparedness capabilities, as demonstrated by the rapid identification and administration of antidotes and effective collaborations between key partners, can contribute to the management of broader publichealth emergencies in rural areas.

Federal statistic figures show that the Brazilian States altogether have, in their respective territories, a collection of taxes which is higher than the Union one. The highest collection of the Central Government which is shown at the official statistics is due to the excess of collection of the federal taxes over the ones of the States; this usually happens in five or six states, of which, in 1964 Guanabara and São Paulo were responsible for 91% of this difference. One can not change the present system of competence in PublicHealth Services in the three levels--central, regional and local--without modifying at the same time the present Brazilian tributary system, where the municipal governments received back in 1962 only 5.6 of the general collection of taxes. Figures from 1955 show that the per capita cost of PublicHealth Services in Brazil, comprising the three levels, was Cr 123 Cr dollars dollars ( 1.82 US dollars), and in 1962, Cr 827 (US 2.30 US dollars). These three levels of government reserved in 1955, 5.6% of the money spent in its total expenditure for PublicHealth activities; this percentage declined to 4.5% in 1962. In relation to the sum invested on PublicHealth government activities, the Union spent in 1962, 36.4% of the total expenses, the States 59.3% and the counties only 5.5%. There is a great disproportion in the distribution of PublicHealth expenditure among the various Brazilian States, ranging from a minimal percentage over the total public expenses such as the case of Goiás (1.6% in 1964) up to a maximum of 17.2% in Pará in the same year. There is also a considerable variation from one state to another and in 1964 it ranged from the lowest limit of 70 Cr dollars in Maranhão up to 5.217 in Guanabara. If we analyze the per capita expenses of each state with PublicHealth activities, using 1964 and 1954 figures represented in 1964 monetary values, we can verify that the expenditure of 20 states dropped of 17.2%. One can not know

With the potential to save nearly 30 000 lives per year in the United States, autonomous vehicles portend the most significant advance in auto safety history by shifting the focus from minimization of postcrash injury to collision prevention. I have delineated the important publichealth implications of autonomous vehicles and provided a brief analysis of a critically important ethical issue inherent in autonomous vehicle design. The broad expertise, ethical principles, and values of publichealth should be brought to bear on a wide range of issues pertaining to autonomous vehicles.

With the potential to save nearly 30 000 lives per year in the United States, autonomous vehicles portend the most significant advance in auto safety history by shifting the focus from minimization of postcrash injury to collision prevention. I have delineated the important publichealth implications of autonomous vehicles and provided a brief analysis of a critically important ethical issue inherent in autonomous vehicle design. The broad expertise, ethical principles, and values of publichealth should be brought to bear on a wide range of issues pertaining to autonomous vehicles. PMID:28207327

As publichealth practitioners and as clinicians we are taught to care for our patients, and for our community members. But how much do we teach and learn about how to lead, manage and care for our colleagues, our team members and ourselves? This paper emphasizes the need for leadership learning and teaching to become an essential element of the practice of publichealth. The paper presents the author's perspective on the leadership skills required for publichealth and describes a five-day intensive course designed to enable participants to develop these skills over time. The paper briefly covers leadership definitions, styles and types and key leadership skills. It mainly focuses on the design and ethos of the course, skills self-assessment, group interaction and methods for developing and refining leadership skills. The course uses a collaborative learning approach where the power differential between teachers, facilitators, guests and participants is minimized. It is based on creating an environment where any participant can reveal his or her stories, successes, failures, preferences and dislikes in a safe manner. It encourages continual, constructive individual reflection, self-assessment and group interaction. The course is aimed at the practice of publichealth leadership, with a particular emphasis on the leadership of self, of knowing oneself, and of knowing and understanding colleagues retrospectively as well as prospectively. The most important outcome is the design and implementation of participants' own plans for developing and nurturing their leadership skills. Significance for publichealthThe nature of publichealth is changing rapidly and increasing in complexity. These changes include major shifts in the burden of disease and the insatiable demands of clinical medicine swamping those of publichealth. Publichealth practitioners have failed over many years to systematically ensure that leadership and management skills are essential parts of public

As publichealth practitioners and as clinicians we are taught to care for our patients, and for our community members. But how much do we teach and learn about how to lead, manage and care for our colleagues, our team members and ourselves? This paper emphasizes the need for leadership learning and teaching to become an essential element of the practice of publichealth. The paper presents the author’s perspective on the leadership skills required for publichealth and describes a five-day intensive course designed to enable participants to develop these skills over time. The paper briefly covers leadership definitions, styles and types and key leadership skills. It mainly focuses on the design and ethos of the course, skills self-assessment, group interaction and methods for developing and refining leadership skills. The course uses a collaborative learning approach where the power differential between teachers, facilitators, guests and participants is minimized. It is based on creating an environment where any participant can reveal his or her stories, successes, failures, preferences and dislikes in a safe manner. It encourages continual, constructive individual reflection, self-assessment and group interaction. The course is aimed at the practice of publichealth leadership, with a particular emphasis on the leadership of self, of knowing oneself, and of knowing and understanding colleagues retrospectively as well as prospectively. The most important outcome is the design and implementation of participants’ own plans for developing and nurturing their leadership skills. Significance for publichealth The nature of publichealth is changing rapidly and increasing in complexity. These changes include major shifts in the burden of disease and the insatiable demands of clinical medicine swamping those of publichealth. Publichealth practitioners have failed over many years to systematically ensure that leadership and management skills are essential parts of

Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of PublicHealth (BSPH) in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in publichealth was an important first step for the development of this observatory. This new academia-based observatory is an innovative publichealth research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a publichealth observatory and its role in addressing social health inequalities in local urban settings is discussed.

While climate change is inherently a global problem, its publichealth impacts will be experienced most acutely at the local and regional level, with some jurisdictions likely to be more burdened than others. The publichealth infrastructure in the U.S. is organized largely as an interlocking set of public agencies at the federal, state and local level, with lead responsibility for each city or county often residing at the local level. To understand how directors of local publichealth departments view and are responding to climate change as a publichealth issue, we conducted a telephone survey with 133 randomly selected local health department directors, representing a 61% response rate. A majority of respondents perceived climate change to be a problem in their jurisdiction, a problem they viewed as likely to become more common or severe over the next 20 years. Only a small minority of respondents, however, had yet made climate change adaptation or prevention a top priority for their health department. This discrepancy between problem recognition and programmatic responses may be due, in part, to several factors: most respondents felt personnel in their health department--and other key stakeholders in their community--had a lack of knowledge about climate change; relatively few respondents felt their own health department, their state health department, or the Centers for Disease Control and Prevention had the necessary expertise to help them create an effective mitigation or adaptation plan for their jurisdiction; and most respondents felt that their health department needed additional funding, staff and staff training to respond effectively to climate change. These data make clear that climate change adaptation and prevention are not currently major activities at most health departments, and that most, if not all, local health departments will require assistance in making this transition. We conclude by making the case that, through their words and actions

Large airports with the related infrastructure, businesses and industrial activities affect the health of the population living, travelling and working in the surroundings of or at the airport. The employment and contributions to economy from the airport and related operations are expected to have a beneficial effect, which, however, is difficult to quantify. More pertinent data are available on the, largely negative, health effects of environmental factors, such as air and soil pollution, noise, accident risk, and landscape changes. Information on the concurrent and cumulative impact of these factors is lacking, but is of primary relevance for publichealth policy. A committee of the Health Council of The Netherlands recently reviewed the data on the health impact of large airports. It was concluded that, generally, integrated health assessments are not available. Such assessments, as part of sustainable mobility policy, should accompany the further development of the global aviation system.

This study examines the publication patterns of U.S. academic health sciences librarians. A survey was sent to a random sample of Medical Library Association (MLA) members who work in academic settings. Some survey results are consistent with other research while others vary from the findings of previous studies. Faculty status requiring publication may be an incentive to publish; however, a large percentage of librarians in this study published despite the lack of a requirement. Academic health sciences librarians without advanced degrees other than a master's in library science produced about three quarters of the publications, whereas their colleagues with advanced degrees published slightly more than 25% of the publications. Results concerning professional maturity, position, and geographic location reflect findings of earlier studies of academic librarians' publication patterns. Publication productivity generally increased with professional maturity, most authors held administrative or supervisory positions, and many lived in the Northeast and Midwest regions of the United States. The differences in rates of publication between males and females was not statistically significant after controlling for respondents' professional maturity and position. Recommendations for future research are discussed. PMID:2039902

Worldwide, a child born in 1955 had an average life expectancy at birth of only 48 years. By 2000, the average life expectancy at birth had increased to 66 years and, if past trends continue, is projected to rise to 73 years by 2025. These improvements in longevity have resulted from improved living conditions overall, advances in medical science, and a number of population-level interventions. However, major disparities persist. During the past decade, in low-income countries, average life expectancy at birth increased from 55 to 57 years (3.6%), while increasing from 78 to 80 years (2.6%) in high-income countries. Analogous to the recent MMWR report highlighting 10 publichealth achievements that occurred in the United States over the first 10 years of the new century, this report describes global publichealth achievements during the same period. Experts in global publichealth were asked to nominate noteworthy publichealth achievements that occurred outside of the United States during 2001-2010. From them, 10 have been summarized in this report. As with the previous report, the 10 global publichealth achievements are not ranked in any order. Additional information regarding these achievements is available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6019a5_addinfo.htm.

The scope of this research is to discuss the relevance and need for pedagogical training of university lecturers in the PublicHealth field. The contention is that college teaching is a practice that requires specific training, since it is characterized by complex elements that transcend the mastery of given content. Considering stricto sensu graduate studies as an important stage in the training of future university lecturers, an attempt was made to identify and analyze the subjects and practices of pedagogical training in academic masters and doctorate programs in PublicHealth. To achieve the research aim, this work was based on Pierre Bourdieu's field theory and on Tomaz Tadeu da Silva's curriculum theory. Results indicate that the programs do not consider the aspect of teacher training as a major issue. With regard to the PublicHealth field approximately 61% of masters and 38% of doctorate programs have pedagogical training subjects/practices. Furthermore, there is a tendency for technical-instrumental training, which is in line with the history of the PublicHealth field. The conclusion is that there is a need to develop a culture that values college and graduate PublicHealth teaching, considering the complexity of pedagogical practice in all its dimensions.

A high level expert panel discussed how climate and health services could best collaborate to improve publichealth. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the publichealth community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719

A high level expert panel discussed how climate and health services could best collaborate to improve publichealth. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the publichealth community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.

Publichealth has typically investigated health issues using methods from the positivistic paradigm. Yet these approaches, although they are able to quantify the problem, may not be able to explain the social reasons of why the problem exists or the impact on those affected. This article will provide a brief overview of a sociological theory that provides methods and a theoretical framework that has proven useful in understanding publichealth problems and developing interventions.

The history and development of Ontario's new publichealth agency, PublicHealth Ontario, is explored. The governance model and organizational structure are identified along with an overview of the relationship with the Ontario Ministry of Health and Long-Term Care. The strategic mission and vision are described as are the key functions. The building of the organization through new investments and divestments is explained. The paper concludes with an overview of the challenges encountered and the opportunities ahead.

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Executive summary In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and publichealth approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect publichealth. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on publichealth issues arising from drug control policy and to inform and encourage a central focus on publichealth evidence and outcomes in drug policy debates, such as the important deliberations of

The integration of publichealth practices with federal health care for American Indians and Alaska Natives (AI/ANs) largely derives from three major factors: the sovereign nature of AI/AN tribes, the sociocultural characteristics exhibited by the tribes, and that AI/ANs are distinct populations residing in defined geographic areas. The earliest services consisted of smallpox vaccination to a few AI/AN groups, a purely publichealth endeavor. Later, emphasis on publichealth was codified in the Snyder Act of 1921, which provided for, among other things, conservation of the health of AI/AN persons. Attention to the community was greatly expanded with the 1955 transfer of the Indian Health Service from the US Department of the Interior to the PublicHealth Service and has continued with the assumption of program operations by many tribes themselves. We trace developments in integration of community and publichealth practices in the provision of federal health care services for AI/AN persons and discuss recent trends. PMID:24758580

This document contains major provisions of Viet Nam's 1989 law on the protection of publichealth. Chapter 1 sets out the rights of citizens to health care and health-promoting activities and environments as well as the obligations of citizens to implement the publichealth provisions of the law. Chapter 7 covers maternal-child health care and family planning (FP). Individuals may choose their method of birth control, and couples should have no more than two children. Coercion in the implementation of FP is forbidden. Women have the right to abortion and to reproductive health care. Abortions and IUD removals must be performed by licensed individuals. Employers of women must respect reproductive health policies dealing with pregnancy, child birth, breast feeding, and FP. Women may not be employed in arduous jobs or in jobs that are harmful to health. Health services for children will be expanded to provide necessary services, and parents must see that their children have the appropriate examinations and immunizations. The care of handicapped children will be organized by the Ministry of Health and the Minister of Labour, War Invalids, and Social Affairs.

The paper considers the long-term trajectory of publichealth and whether a 'Golden Era' in PublicHealth might be coming to an end. While successful elements of the 20th century policy approach need still to be applied in the developing world, two significant flaws are now apparent within its core thinking. It assumes that continuing economic growth will generate sufficient wealth to pay for the publichealth infrastructure and improvement needed in the 21st century when, in reality, externalised costs are spiralling. Secondly, there is evidence of growing mismatch between ecosystems and human progress. While 20th century development has undeniably improved publichealth, it has also undermined the capacity to maintain life on a sustainable basis and has generated other more negative health consequences. For these and other reasons a rethink about the role, purpose and direction of publichealth is needed. While health has to be at the heart of any viable notion of progress the dominant policy path offers new versions of the 'health follows wealth' position. The paper posits ecological publichealth as a radical project to reshape the conditions of existence. Both of these broad paths require different functions and purposes from their institutions, professions and politicians. The paper suggests that eco-systems pressures, including climate change, are already adding to pressure for a change of course.

Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the publichealth setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant publichealth programming and culturally sensitive publichealth research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for publichealth professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Publichealth professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in publichealth educational institutions.

The health benefits of physical activity are well documented, and the important role that schools and physical education (PE) can play in reducing sedentary behavior and contributing to population health has been identified. Although effective teaching is ultimately judged by student achievement, a major component of teacher and school effectiveness studies has been student engagement. Thus, in PE, it is important to assess the teaching and learning processes related to expected outcomes, including what students and teachers do and how lessons are delivered. Within a publichealth context, it is then important to assess how teachers provide students with ample health-enhancing physical activity to help them become physically fit and to learn generalizable movement and behavioral skills designed to promote physical activity and fitness outside of class time. In this article, we emphasize that the future of PE in our nation's schools will depend on the ability of schools to provide programs that are perceived to be of importance to the public; moreover, we believe that the future of PE rests on the effectiveness of PE teachers to operate within a publichealth context. In addition, we also provide a summary of teacher effectiveness research within a publichealth context and offer visions for the future assessment and evaluation of PE teacher effectiveness that move beyond the PE lesson to include components of the comprehensive school physical activity model.

Historically, publichealth agencies have had relatively few formal partnerships with private business. However, both groups share an interest in ensuring a healthy population. Businesses have a financial interest in supporting organized publichealth efforts; in turn, business partnerships can increase the reach and effectiveness of publichealth. This paper makes the case for the business sector's participation in the broad publichealth system and its support of governmental publichealth agencies. Examples of past and current partnerships exemplify how publichealth efforts benefit business and suggest opportunities for future collaboration to improve the public's health.

The upcoming publichealth law must serve as the basis for publichealth reform. The text of the law should allow publichealth structures to be modernized and adapted to the country's new needs. A broader concept of publichealth and a redefinition of its functions and basic services are required. Some of the main suggestions for the upcoming law are the establishment of a Spanish Agency for PublicHealth and a PublicHealth Council, the design of a Spanish Strategy of PublicHealth, and reform of professional training.

In this article, we compared the characteristics of public and private accredited publichealth training programs. We analyzed the distinct opportunities and challenges that publicly funded schools of publichealth face in preparing the nation’s publichealth workforce. Using our experience in creating a new, collaborative public school of publichealth in the nation’s largest urban public university system, we described efforts to use our public status and mission to develop new approaches to educating a workforce that meets the health needs of our region and contributes to the goal of reducing health inequalities. Finally, we considered policies that could protect and strengthen the distinct contributions that public schools of publichealth make to improving population health and reducing health inequalities. PMID:25706006

This study identifies the health-related services provided by publichealth educators. The investigators, with the help of practicing publichealth educators, created the list of health-related services. Respondents received questionnaires in 2001 and 2007. Thus, this study determined the changes in health-related services provided over a 6-year period. Respondents ranked up to five health-related services by the amount of time spent delivering each health-related service. The list of health-related services presented in a 2001 survey and a 2007 survey were identical. As in 2001, this list in the 2007 survey captured the breadth of health-related services provided, with one exception. In 2007, several participants wrote-in "emergency preparedness/bioterrorism." The types of health-related services provided did not change over the 6-year period; however, the ranking of these services did change. Most notably, nutrition education and involvement with physical activity moved up in the ranking in 2007.

Recent changes in policymaking, such as the passage of the Patient Protection and Affordable Care Act, have ushered in a new era in community health partnerships. To investigate characteristics of effective collaboration between hospitals, their parent systems, and the publichealth community, with the support of major hospital, medical, and publichealth associations, we compiled a list of 157 successful partnerships. This set was subsequently narrowed to 12 successful and diverse partnerships. After conducting site visits in each of the partnerships' communities and interviews with key partnership participants, we extracted lessons about their success. The lessons we have learned from our investigation have the potential to assist others as they develop partnerships.

To analyze the extent of academic interest in quality improvement (QI) initiatives in medical practice, annual publication trends for the most well-known QI methodologies being used in health care settings were analyzed. A total of 10 key medical- and business-oriented library databases were examined: PubMed, Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, Scopus, the Cochrane Central Register of Controlled Trials, ABI/INFORM, and Business Source Complete. A total of 13 057 articles were identified that discuss at least 1 of 10 well-known QI concepts used in health care contexts, 8645 (66.2%) of which were classified as original research. "Total quality management" was the only methodology to demonstrate a significant decline in publication over time. "Continuous quality improvement" was the most common topic of study across all publication years, whereas articles discussing Lean methodology demonstrated the largest growth in publication volume over the past 2 decades. Health care QI publication volume increased substantially beginning in 1991.

The applicability of remote sensing in the form of aerial photography to urban publichealth problems is examined. Environmental characteristics are analyzed to determine if health differences among areas could be predicted from the visual expression of remote sensing data. The analysis is carried out on a socioeconomic cross-sectional sample of census block groups. Six morbidity and mortality rates are the independent variables while environmental measures from aerial photographs and from the census constitute the two independent variable sets. It is found that environmental data collected by remote sensing are as good as census data in evaluating rates of health outcomes.

The prevalence of new cases of diabetes continues to increase, and the health burden for those with diabetes remains high. This is attributable, in part, to low adoption of evidence-based interventions for diabetes prevention and control. Law is a critical tool for health improvement, yet assessments reported in this paper indicate that federal, state, and local laws give only partial support to guidelines and evidence-based interventions relevant to diabetes prevention and control. Publichealth practitioners and policymakers who are concerned with the human, fiscal, and economic costs of the epidemic can explore new ways to translate the evidence base for diabetes prevention and control into effective laws and policies.

The current epidemic of violence in America threatens not only our physical health but also the integrity of basic social institutions such as the family, the communities in which we live, and our health care system. Publichealth brings a new vision of how Americans can work together to prevent violence. This new vision places emphasis on preventing violence before it occurs, making science integral to identifying effective policies and programs, and integrating the efforts of diverse scientific disciplines, organizations, and communities. A sustained effort at all levels of society will be required to successfully address this complex and deeply rooted problem.

International literature has established that racism contributes to ill-health of migrants, ethnic minorities and indigenous peoples. Racism generally negates wellbeing, adversely affecting physical and psychological health. Numerous studies have shown that media contribute marginalizing particular ethnic and cultural groups depicting them primarily as problems for and threats to the dominant. This articles frames media representations of, and their effect on, the indigenous Maori of Aotearoa, New Zealand within the ongoing processes of colonization. We argue that reflects the media contribution to maintenance and naturalisation of colonial relationships and seek to include critical media scholarship in a critical publichealth psychology.

This training manual provides information needed to meet the minimum EPA standards for certification as a commercial applicator of pesticides in the publichealth pest control category. The text discusses pests such as roaches, bedbugs, bees, mosquitoes, gnats, flies, and rodents with possible control measures provided. (CS)

Patient activation is a new term for a perennial problem. People know what they need to do for their health: exercise, eat right, and get enough rest--but how are they motivated to actually do these things? This is what patient activation is. From this author's vantage point as a medical librarian, public libraries are well-placed to be part of…

There is a bewildering array of nutrition information available to the public and to professionals. Nutrition messages are often conflicting, confusing, and often simply rhetoric. More consumer research is needed to understand more fully the best way to communicate health messages, recommendations, ...

In this paper, we respond to AIDS denialist arguments that HIV does not cause AIDS, that antiretroviral drugs are not useful, and that there is no evidence of large-scale deaths from AIDS, and discuss the key implications of the relationship between AIDS denialism and publichealth practice. We provide a brief history of how the cause of AIDS was investigated, of how HIV fulfills Koch's postulates and Sir Bradford Hil's criteria for causation, and of the inconsistencies in alternatives offered by denialists. We highlight clinical trials as the standard for assessing efficacy of drugs, rather than anecdotal cases or discussions of mechanism of action, and show the unanimous data demonstrating antiretroviral drug efficacy. We then show how statistics on mortality and indices such as crude death rate, life expectancy, child mortality, and population growth are consistent with the high mortality from AIDS, and expose the weakness of statistics from death notification, quoted by denialists. Last we emphasize that when denialism influences publichealth practice as in South Africa, the consequences are disastrous. We argue for accountability for the loss of hundreds of thousands of lives, the need to reform publichealth practice to include standards and accountability, and the particular need for honesty and peer review in situations that impact publichealth policy.

This article presents comments and observations given by Dr. Shiriki K. Kumanyika as the Lautenberg Award Lecture at the commencement of the University of Medicine and Dentistry of New Jersey-Rutgers School of PublicHealth, May 20, 2013. The award is named after Senator Frank Lautenberg, who served as a U.S. Senator from New Jersey during 1982 to…

This manual provides information needed to meet the standards for pesticide applicator certification. It presents pest control guidelines for those organisms of publichealth significance. Fact sheets with line drawings discuss pests such as cockroaches, bedbugs, lice, ants, beetles, bats, birds, and rodents. (CS)

This is an opinion piece that proposes a reflection on the current status of the interface between cyberculture and publichealth and its use as a means for research, not as a mere tool. Cyberculture thus represents a new form of interface between people. And it is precisely "through" and "by means of" social relations that individuals acquire skills and communication techniques. The forms and the means of the relationship alters, but the ends remain unchanged, namely to be in contact with other humans. In recent decades, with the advent of computers, the Internet and all the technological apparatus, human relationships are dependent on them, which is the modern so-called cyberculture. This now affects all areas of activity, and publichealth cannot be left behind, taking advantage of it and its benefits for its development. It is necessary to keep abreast of these changes and raise them from the theoretical to the practical plane, not only implementing publichealth policies but also taking the socio-virtual aspects into consideration. It is also necessary for the professionals involved to be updated on new forms of communication, interaction, research methodology, preparation of instruments, sampling approaches and all other phenomena arising from cyberculture that will work in partnership with publichealth.

This article presents the conceptual basis for veterinary publichealth-VPH, including historical aspects of its constitution and development, its fields of action, and its current challenges. It also presents a reflection on VPH within the frame of the veterinary services and it finally proposes that education plays a fundamental role in order to face the challenges of a new era.

This manual gives general control principles and specific information on control of mosquitoes, flies, bedbugs, fleas, lice, cockroaches, venomous arthropods, ticks and chiggers, and rodents. The specific information includes life-cycles and habitats, publichealth importance, non-chemical control, and control with pesticides. (BB)

Most patients with chronic disease are prescribed multiple medications, which are recorded in their personal health records. This is rich information for clinical publichealth researchers but also a challenge to analyse. This paper describes the method that was undertaken within the PublicHealth Research Data Management System (PHReDMS) to map medication data retrieved from individual patient health records for population health researcher’s use. The PHReDMS manages clinical, health service, community and survey research data within a secure web environment that allows for data sharing amongst researchers. The PHReDMS is currently used by researchers to answer a broad range of questions, including monitoring of prescription patterns in different population groups and geographic areas with high incidence/prevalence of chronic renal, cardiovascular, metabolic and mental health issues. In this paper, we present the general notion of abstraction network, a higher level network that sits above a terminology and offers compact and more easily understandable view of its content. We demonstrate the utilisation of abstraction network methodology to examine medication data from electronic medical records to allow a compact and more easily understandable view of its content. PMID:28149446

The PublicHealth Training Center (PHTC) national program was first established at accredited schools of publichealth in 2000. The PHTC program used the US Health Resources and Services Administration's grants to build workforce development programs, attracting schools as training providers and the workforce as training clients. This article is a reflection on the experience of two schools, whose partnership supported one of the PHTCs, for the purpose of opening a conversation about the future of continuing education throughout schools and degree programs of publichealth. This partnership, the Pennsylvania & Ohio PublicHealth Training Center (POPHTC), concentrated its funding on more intensive training of public healthcare workers through a relatively narrow inventory of courses that were delivered typically in-person rather than by distance-learning technologies. This approach responded to the assessed needs and preferences of the POPHTC's workforce population. POPHTC's experience may not be typical among the PHTCs nationally, but the collective experience of all PHTCs is instructive to schools of publichealth as they work to meet an increasing demand for continuing education from the publichealth workforce.

The renewed interest in 'public sociology' has sparked debate and discussion about forms of sociological work and their relationship to the State and civil society. Medical sociologists are accustomed to engaging with a range of publics and audiences inside and outside universities and are in a position to make an informed contribution to this debate. This paper describes how some of the debates about sociological work are played out through a 'health impact assessment' of a proposed housing renewal in a former coal mining community. We explore the dynamics of the health impact assessment process and relate it to wider debates, current in the social sciences, on the 'new knowledge spaces' within which contentious public issues are now being discussed, and the nature of different forms of expertise. The role of the 'public sociologist' in mediating the relationships between the accounts and interpretations of lay participants and the published 'evidence' is described as a process of mutual learning between publics, professionals and social scientists. It is argued that the continued existence and development of any meaningful 'professional sociology' requires an openness to a 'public sociology' which recognises and responds to new spaces of knowledge production.

South Africa has 4 publichealth training institutions: the Transvaal School of PublicHealth, the PublicHealth Programme of the University of the Western Cape, the Natal Institute of Community Health Education, and the Eastern Cape School of PublicHealth. They are interinstitutional (universities, polytechnic schools, health service providers, statutory research councils, and nongovernmental organizations). A steering committee heads up each institution. One person leads the committee, managing all activities and making sure that all activities fulfill the requirements of the steering committee. The Epidemiological Society of Southern Africa also contributes to publichealth training through its annual forum for publichealth researchers and meetings of publichealth personnel, where they talk about publichealth training needs. Interest in publichealth training reemerged in the late 1980s, mainly due to the dismantling of apartheid, which called for a restructuring of the publichealth service. Primary health care is the focus of all South Africa's publichealth institutions. Courses convey community-oriented approaches in the design of health programs and research. They use a multidisciplinary approach to education. They examine socioeconomic conditions affecting health as well as the biomedical aspects of publichealth. The Transvaal School of PublicHealth targets post-basic and post-graduate health staff at the middle or senior level positions. On the other hand, the Eastern Cape School of PublicHealth targets field workers, primary health care workers, and publichealth professionals. Currently, the programs only provide a Master of PublicHealth. As South Africa makes its way to democracy and with adequate funding, publichealth training in South Africa will result in positive efforts helping all of Africa.

In preparation to update the Dental PublicHealth specialty competencies, the Expert Panel determined that a needs assessment be conducted. A nine item open and close ended survey developed by the Expert Panel was used to collect data on the Diplomates current work environment, the utility of the current set of Dental PublicHealth competencies, and to identify any gaps in the current competencies. In 2015, the survey was administered to all active Diplomates of the American Board of Dental PublicHealth. One hundred and nine Diplomates responded. Diplomates overwhelmingly reported that each of the ten current competencies were still relevant for Dental PublicHealth specialists in the 21(st) Century, but needed to be updated to be more contemporary. Domains suggested to achieve this were interprofessional care, cultural competency, health literacy, and evidence-based dentistry.

Tobacco remains the leading preventable cause of death worldwide. In particular, people with mental illness are disproportionately affected with high smoking prevalence; they account for more than 200,000 of the 520,000 tobacco-attributable deaths in the United States annually and die on average 25 years prematurely. Our review aims to provide an update on smoking in the mentally ill. We review the determinants of tobacco use among smokers with mental illness, presented with regard to the publichealth HAVE framework of "the host" (e.g., tobacco user characteristics), the "agent" (e.g., nicotine product characteristics), the "vector" (e.g., tobacco industry), and the "environment" (e.g., smoking policies). Furthermore, we identify the significant health harms incurred and opportunities for prevention and intervention within a health care systems and larger health policy perspective. A comprehensive effort is warranted to achieve equity toward the 2025 Healthy People goal of reducing US adult tobacco use to 12%, with attention to all subgroups, including smokers with mental illness. Expected final online publication date for the Annual Review of PublicHealth Volume 38 is March 20, 2017. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Climate change poses a major threat to publichealth. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet publichealth engagement at the intersection of publichealth, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with publichealth and climate change professionals and thematic analysis. Barriers to publichealth engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change’s health impacts and programmatic connections. Institutional barriers include a lack of publichealth capacity, authority, and leadership; a narrow framework for publichealth practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current publichealth practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase publichealth sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities. PMID:26690194

Climate change poses a major threat to publichealth. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet publichealth engagement at the intersection of publichealth, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with publichealth and climate change professionals and thematic analysis. Barriers to publichealth engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change's health impacts and programmatic connections. Institutional barriers include a lack of publichealth capacity, authority, and leadership; a narrow framework for publichealth practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current publichealth practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase publichealth sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities.

This report is a part of the program of the National Center for Health Statistics to provide current statistics as baseline data for the evaluation, planning, and administration of health programs. Part I presents data concerning the occupational fields: (1) administration, (2) anthropology and sociology, (3) data processing, (4) basic sciences,…

This is a brief discussion of wildfire smoke and its health effects along with tools available to provide publichealth guidance during wildfire events, including the Wildfire Smoke Guide for PublicHealth Officials

The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and publichealth risks. To accomplish this, close communication and collaboration is needed among HAB scientists, publichealth researchers and local, state and tribal health departments at academic, community outreach, and policy levels. PMID:27616971

The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and publichealth risks. To accomplish this, close communication and collaboration is needed among HAB scientists, publichealth researchers and local, state and tribal health departments at academic, community outreach, and policy levels.

Improved understanding of the multilayer regulation of the human genome has led to a greater appreciation of environmental, nutritional, and epigenetic risk factors for human disease. Chromatin remodeling, histone tail modifications, and DNA methylation are dynamic epigenetic changes responsive to external stimuli. Careful interpretation can provide insights for actionable publichealth through collaboration between population and basic scientists and through integration of multiple data sources. We review key findings in environmental epigenetics both in human population studies and in animal models, and discuss the implications of these results for risk assessment and publichealth protection. To ultimately succeed in identifying epigenetic mechanisms leading to complex phenotypes and disease, researchers must integrate the various animal models, human clinical approaches, and human population approaches while paying attention to life-stage sensitivity, to generate effective prescriptions for human health evaluation and disease prevention. PMID:24641556

Extensive water damage resulting from major flooding is often associated with mold growth if materials are not quickly and thoroughly dried. Exposure to fungal contamination can lead to several infectious and noninfectious health effects impacting the respiratory system, skin, and eyes. Adverse health effects can be categorized as infections, allergic or hypersensitivity reactions, or toxic-irritant reactions. Workers and building occupants can minimize their exposure to mold by avoiding areas with excessive mold growth, using personal protective equipment, and implementing environmental controls. Occupational health professionals should encourage workers to seek health care if they experience any symptoms that may be linked to mold exposure.

Globalisation is a defining economic and social trend of the past several decades. Globalisation affects health directly and indirectly and creates economic and health disparities within and across countries. The political response to address these disparities, exemplified by the Millennium Development Goals, has put pressure on the global community to redress massive inequities in health and other determinants of human capability across countries. This, in turn, has accelerated a transformation in the architecture of global health governance. The entrance of new actors, such as private foundations and multi-stakeholder initiatives, contributed to a doubling of funds for global health between 2000 and 2010. Today the governance of publichealth is in flux, with diminished leadership from multilateral institutions, such as the WHO, and poor coherence in policy and programming that undermines the potential for sustainable health gains. These trends pose new challenges and opportunities for global publichealth, which is centrally concerned with identifying and addressing threats to the health of vulnerable populations worldwide.

This article describes a publichealth leadership certificate curriculum developed by the Commonwealth PublicHealth Training Center for employees in publichealth and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Publichealth employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited publichealth in Virginia.

registered users, followed by librarians, dieticians, medical officers of health, and nutritionists. The majority of users (67%) access the website from direct traffic (e.g., have the health-evidence.ca webpage bookmarked, or type it directly into their browser). Conclusions Consistent use of health-evidence.ca and particularly the searching for reviews that correspond with current publichealth priorities illustrates that health-evidence.ca may be playing an important role in achieving evidence-informed publichealth decision making. PMID:20718970

Extensive water damage after major hurricanes and floods increases the likelihood of mold contamination in buildings. This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects. Where uncertainties in scientific knowledge exist, practical applications designed to be protective of a person's health are presented. Evidence is included about assessing exposure, clean-up and prevention, personal protective equipment, health effects, and publichealth strategies and recommendations. The recommendations assume that, in the aftermath of major hurricanes or floods, buildings wet for <48 hours will generally support visible and extensive mold growth and should be remediated, and excessive exposure to mold-contaminated materials can cause adverse health effects in susceptible persons regardless of the type of mold or the extent of contamination. For the majority of persons, undisturbed mold is not a substantial health hazard. Mold is a greater hazard for persons with conditions such as impaired host defenses or mold allergies. To prevent exposure that could result in adverse health effects from disturbed mold, persons should 1) avoid areas where mold contamination is obvious; 2) use environmental controls; 3) use personal protective equipment; and 4) keep hands, skin, and clothing clean and free from mold-contaminated dust. Clinical evaluation of suspected mold-related illness should follow conventional clinical guidelines. In addition, in the aftermath of extensive flooding, health-care providers should be watchful for unusual mold-related diseases. The development of a publichealth surveillance strategy among persons repopulating areas after extensive flooding is recommended to assess potential health effects and the effectiveness of prevention efforts. Such a surveillance program will help CDC and state and local publichealth officials refine the guidelines for exposure avoidance, personal protection

This report identifies a broad spectrum of issues affecting women's health and is divided into four sections: (1) social factors affecting women's health; (2) women's physical health and well-being; (3) health concerns of older women; and (4) issues related to alcohol, drug use and abuse, and the mental health of women. The PublicHealth Service…

Shiga toxin-producing Escherichia coli (STEC) strains are the only pathogenic group of E. coli that has a definite zoonotic origin, with ruminants and, in particular, cattle being recognized as the major reservoir. Most human STEC infections are food borne, but the routes of transmission include direct contact with animals and a variety of environment-related exposures. Therefore, STEC publichealth microbiology spans the fields of medical, veterinary, food, water, and environmental microbiology, requiring a "One Health" perspective and laboratory scientists with the ability to work effectively across disciplines. Publichealth microbiology laboratories play a central role in the surveillance of STEC infections, as well as in the preparedness for responding to outbreaks and in providing scientific evidence for the implementation of prevention and control measures. This article reviews (i) how the integration of surveillance of STEC infections and monitoring of these pathogens in animal reservoirs and potential food vehicles may contribute to their control; (ii) the role of reference laboratories, in both the publichealth and veterinary and food sectors; and (iii) the publichealth perspectives, including those related to regulatory issues in both the European Union and the United States.

In this paper, we assess the capacity of Florida's publichealth departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded publichealth services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of publichealth services.

Publichealth programs succeed and survive if organizations and coalitions address 6 key areas. (1) Innovation to develop the evidence base for action; (2) a technical package of a limited number of high-priority, evidence-based interventions that together will have a major impact; (3) effective performance management, especially through rigorous, real-time monitoring, evaluation, and program improvement; (4) partnerships and coalitions with public- and private-sector organizations; (5) communication of accurate and timely information to the health care community, decision makers, and the public to effect behavior change and engage civil society; and (6) political commitment to obtain resources and support for effective action. Programs including smallpox eradication, tuberculosis control, tobacco control, polio eradication, and others have made progress by addressing these 6 areas.

This article discusses the part-time/Internet-based Master of PublicHealth (MPH) program at the Johns Hopkins Bloomberg School of PublicHealth (JHSPH). The Johns Hopkins Bloomberg School of PublicHealth was the first school of publichealth in the United States to offer a Master of PublicHealth program via the Internet. The JHSPH MPH Program…

There have been numerous efforts to create comprehensive databases from multiple sources to monitor the dynamics of publichealth and most specifically to detect the potential threats of bioterrorism before widespread dissemination. But there are not many evidences for the assertion that these systems are timely and dependable, or can reliably identify man made from natural incident. One must evaluate the value of so called 'syndromic surveillance systems' along with the costs involved in design, development, implementation and maintenance of such systems and the costs involved in investigation of the inevitable false alarms1. In this article we will introduce a new perspective to the problem domain with a shift in paradigm from 'surveillance' toward 'awareness'. As we conceptualize a rather different approach to tackle the problem, we will introduce a different methodology in application of information science, computer science, cognitive science and human-computer interaction concepts in design and development of so called 'publichealth situation awareness systems'. We will share some of our design and implementation concepts for the prototype system that is under development in the Center for Biosecurity and PublicHealth Informatics Research, in the University of Texas Health Science Center at Houston. The system is based on a knowledgebase containing ontologies with different layers of abstraction, from multiple domains, that provide the context for information integration, knowledge discovery, interactive data mining, information visualization, information sharing and communications. The modular design of the knowledgebase and its knowledge representation formalism enables incremental evolution of the system from a partial system to a comprehensive knowledgebase of 'publichealth situation awareness' as it acquires new knowledge through interactions with domain experts or automatic discovery of new knowledge.

When drawing up the portrait of "urban figures of publichealth", in 1998, Didier Fassin considered Toulouse to be one of the worthy "local experiments". Fifteen years after his precursory work, the recently developed local public policy against health social differences gives an opportunity to question ourselves about the effectiveness of such a quality then associated to the city. A cognitive analysis of the elaboration of the Toulousian healthpublic policy meaning enables to notice that the process of health legitimization on a local scale takes the following forms. On the one hand, renaming health as a legitimate object of public policies sets it up as a common wealth. On the other hand, local public policy puts the emphasis on health education and tries to increase the standing of social appraisal coming from associative experiments and abilities of the inhabitants themselves. Finally, it calls for citizens' mobilization and solidarity in order to promote a "health democracy" able to struggle efficiently against health social differences.

Routine vaccination has been hailed as one of the top publichealth achievements of the last century. However, despite the reduced number of cases of and deaths from vaccine-preventable diseases such as pertussis and measles, outbreaks continue to occur as more parents fail to adequately vaccinate their children because of misinformation about immunizations. This article describes the challenges of making sure all children in the United States are fully immunized and what physicians need to know to effectively work with parents who may be hesitant to vaccinate their children.

We describe the evolution of the organization of publichealth services in the city of Barcelona (Catalonia, Spain) until the creation of the Barcelona PublicHealth Agency. This Agency is a consortium created by the Barcelona City Council and the Government of Catalonia as the sole entity responsible for regional and local publichealth services in the city. The underlying logic for the Agency's design, as well as its mission, vision and value statements, strategy, services' portfolio, and the role of leadership in the process, are analyzed. Aspects related to the Agency's quality and communication plans, as well as the design of its processes, and its policy in terms of alliances for research and training in publichealth, are discussed. Finally, the main challenges for the future are described.

Objective To describe the use of poison center data for publichealth surveillance from the poison center, local, state, and federal publichealth perspectives and to generate meaningful discussion on how to address the challenges to collaboration. Introduction Since 2008, poisoning has become the leading cause of injury-related death in the United States (US); since 1980, the poisoning-related fatality rate in the US has almost tripled.1 Many poison-related injuries and deaths are reported to regional poison centers (PCs) which receive about 2.4 million reports of human chemical and poison exposures annually.2 Federal, state, and local publichealth (PH) agencies often collaborate with poison centers and use PC data for publichealth surveillance of poisoning-related health issues. Many state and local PH agencies have partnerships with regional PCs for direct access to local PC data which help them perform this function. At the national level, CDC conducts publichealth surveillance for exposures and illnesses of publichealth significance using the National Poison Data System (NPDS), the national PC reporting database. Though most PC and PH officials agree that PC data play an important role in PH practice and surveillance, collaboration between PH agencies and PCs has been hindered by numerous challenges. To address these challenges and bolster collaboration, the Poison Center and PublicHealth Collaborations Community of Practice (CoP) was created in 2010 by CDC as a means to share experiences, identify best practices, and facilitate relationships among federal, state and local publichealth agencies and PCs. To date, the Poison Center and PublicHealth Collaborations CoP includes over 200 members from state and local publichealth, regional PCs, CDC, the American Association of Poison Control Centers (AAPCC), and the Environmental Protection Agency (EPA). A leadership team was created with representatives of the many stakeholders of the community to drive its

The author traces the development of the concept of health promotion from 1980s policies of the World Health Organization. Two approaches that signify the modernization of publichealth are outlined in detail: the European Health for All targets and the settings approach. Both aim to reorient health policy priorities from a risk factor approach to strategies that address the determinants of health and empower people to participate in improving the health of their communities. These approaches combine classic publichealth dictums with “new” strategies, some setting explicit goals to integrate publichealth with general welfare policy. Health for All, health promotion, and population health have contributed to this reorientation in thinking and strategy, but the focus of health policy remains expenditure rather than investment. PMID:12604477

An analysis of more than two decades of poll results has identified six major trends in public opinion likely to affect the health care system of the 1990s. Americans favor more rather than less health spending, at least as long as the economy remains strong, and they do not think the deficit problem requires cuts in medical care outlays. Should there be a serious economic downturn, however, the public would reverse itself and would favor reduced spending that relies on a different set of strategies than those favored by most health policy experts, particularly in regard to spending for care for the elderly. In either case, the poll results suggest that Americans may be less inclined to participate in newer forms of medical practice, such as health maintenance organizations or preferred provider organizations, than anticipated, and that the commercialization of health care is leading to a decline in public confidence in the leaders of medicine. This latter trend may result in a lack of trust in professionals' views concerning the quality of care and may presage more stringent government involvement in and regulation of health services.

Recent studies from India have challenged the fact that the majority of the people who die by suicide have severe mental illness; they have demonstrated its frequent links to environmental stress, social, cultural, economic, and political correlates. Suicide, a complex phenomenon, is a final common pathway for a variety of causal etiologies. Nevertheless, psychiatry continues to argue for curative solutions based on the reductionistic biomedical model, rather than support publichealth measures to manage the larger sociocultural, economic, and political context. While psychiatry and curative medicine help many people in distress, specific mental health interventions are unlikely to impact secular trends in the rates of suicide. The reduction of population rates of suicide requires a range of publichealth measures. PMID:28031584

US citizens face a growing threat of contracting communicable diseases owing to the high recidivism rate in state and federal prisons, poor screening and treatment of prisoners, and inferior follow-up health care upon their release. Insufficient education about communicable diseases--for prisoners and citizens alike--and other problems, such as prejudice against prisoners, escalating costs, and an unreliable correctional health care delivery system for inmates, all contribute to a publichealth problem that requires careful examination and correction for the protection of everyone involved.

OBJECTIVE To examine public school teachers’ perceptions about general health and mental health, and the way in which they obtained this information. METHODS Qualitative research was conducted with 31 primary and secondary school teachers at a state school in the municipality of Sao Paulo, SP, Southeastern Brazil, in 2010. The teachers responded to a questionnaire containing open-ended questions about mental health and general health. The following aspects were evaluated: Teachers’ understanding of the terms “health and “mental health,” the relevance of the need for information on the subject, the method preferred for obtaining information, their experience with different media regarding such matters, and perceptions about the extent to which this available information is sufficient to support their practice. The data were processed using the Qualiquantisoft software and analyzed according to the Discourse of the Collective Subject technique. RESULTS From the teachers’ perspective, general health is defined as the proper physiological functioning of the body and mental health is related to the balance between mind and body, as a requirement for happiness. Most of the teachers (80.6%) showed great interest in acquiring knowledge about mental health and receiving educational materials on the subject. For these teachers, the lack of information creates insecurity and complicates the management of everyday situations involving mental disorders. For 61.3% of the teachers, television is the medium that provides the most information on the topic. CONCLUSIONS The data indicate that there is little information available on mental health for teachers, showing that strategies need to be developed to promote mental health in schools. PMID:26039397

This document explores the opportunity for scholarship to enhance the evidence base for academic publichealth practice and practice-based research. Demonstrating Excellence in Practice-Based Research for PublicHealth defines practice-based research; describes its various approaches, models, and methods; explores ways to overcome its challenges; and recommends actions for its stakeholders in both academic and practice communities. It is hoped that this document will lead to new partnership opportunities between publichealth researchers and publichealth practitioners to strengthen the infrastructure of publichealth and add new dimensions to the science of publichealth practice. Demonstrating Excellence in Practice-Based Research for PublicHealth is intended for those who produce, participate in, and use practice-based research. This includes academic researchers and educators, publichealth administrators and field staff, clinical health professionals, community-based organizations and professionals, and interested members of the public.

Urban planning, also called city and regional planning, is a multidisciplinary field in which professionals work to improve the welfare of persons and communities by creating more convenient, equitable, healthful, efficient, and attractive places now and for the future. The centerpiece of urban planning activities is a "master plan," which can take many forms, including comprehensive plans, neighborhood plans, community action plans, regulatory and incentive strategies, economic development plans, and disaster preparedness plans. Traditionally, these plans include assessing and planning for community needs in some or all of the following areas: transportation, housing, commercial/office buildings, natural resource utilization, environmental protection, and health-care infrastructure. Urban planning and publichealth share common missions and perspectives. Both aim to improve human well-being, emphasize needs assessment and service delivery, manage complex social systems, focus at the population level, and rely on community-based participatory methods. Both fields focus on the needs of vulnerable populations. Throughout their development, both fields have broadened their perspectives. Initially, publichealth most often used a biomedical model (examining normal/abnormal functioning of the human organism), and urban planning often relied on a geographic model (analysis of human needs or interactions in a spatial context). However, both fields have expanded their tools and perspectives, in part because of the influence of the other. Urban planning and publichealth have been intertwined for most of their histories. In 1854, British physician John Snow used geographic mapping of an outbreak of cholera in London to identify a public water pump as the outbreak's source. Geographic analysis is a key planning tool shared by urban planning and publichealth. In the mid-1800s, planners such as Frederick Law Olmsted bridged the gap between the fields by advancing the concept

Given the publichealth importance of law modernization, we undertook a comparative analysis of policy efforts in 4 states (Alaska, South Carolina, Wisconsin, and Nebraska) that have considered publichealth law reform based on the Turning Point Model State PublicHealth Act. Through national legislative tracking and state case studies, we investigated how the Turning Point Act's model legal language has been considered for incorporation into state law and analyzed key facilitating and inhibiting factors for publichealth law reform. Our findings provide the practice community with a research base to facilitate further law reform and inform future scholarship on the role of law as a determinant of the public's health.

Improving publichealth services requires comprehensively integrating all services including medical, social, community, and publichealth ones. Therefore, developing integrated health information services has to start considering business process, rules and information semantics of involved domains. The paper proposes a business and information architecture for the specification of a future-proof national integrated system, concretely the requirements for semantic integration between publichealth surveillance and clinical information systems. The architecture is a semantically interoperable approach because it describes business process, rules and information semantics based on national policy documents and expressed in a standard language such us the Unified Modeling Language UML. Having the enterprise and information models formalized, semantically interoperable Health IT components/services development is supported.

The problem of foodborne diseases, in which especially food of animals origin and the infected animal is involved, is reviewed. Salmonella and Campylobacter contamination of meat and poultry may today, together with parasites in meat and fish be considered as an increasing publichealth problem. Control and prevention measures, especially including radiation processing is summarized and with regard to specific micro-organisms and parasites and to various food commodities suitable for irradiation purposes. The possibilities of this new processing technique for reduction and probably elimination of pathogens and parasites are discussed and recommendations are given for practical application of radiation in order to eliminate health risks eliminating from contaminated food.

August 2010 marks the centenary of the death of Florence Nightingale, who must be, without doubt, the most famous name in nursing. Most people, even those in the health professions, think of her as 'The Lady with the Lamp'; the heroine of the Crimean War, who tended the sick and wounded soldiers at Scutari. Important though this was, her main contribution, which continued long after Crimea, was in the organization of nursing training, in hospital planning, public and military health, and in effective collection of medical statistics.

In exploring the history of involuntary sterilization in California, I connect the approximately 20 000 operations performed on patients in state institutions between 1909 and 1979 to the federally funded procedures carried out at a Los Angeles County hospital in the early 1970s. Highlighting the confluence of factors that facilitated widespread sterilization abuse in the early 1970s, I trace prosterilization arguments predicated on the protection of publichealth. This historical overview raises important questions about the legacy of eugenics in contemporary California and relates the past to recent developments in health care delivery and genetic screening. PMID:15983269

Many practicing health educators do not feel they possess the skills necessary to critically appraise quantitative research. This publication is designed to help provide practicing health educators with basic tools helpful to facilitate a better understanding of quantitative research. This article describes the major components- title, introduction, methods, analyses, results, and discussion sections-of quantitative research. Readers will be introduced to information on the various types of study designs and seven key questions health educators can use to facilitate the appraisal process. On reading, health educators will be in a better position to determine whether research studies are well designed and executed.

Peak oil is the phenomenon whereby global oil supplies will peak, then decline, with extraction growing increasingly costly. Today's globalized industrial food system depends on oil for fueling farm machinery, producing pesticides, and transporting goods. Biofuels production links oil prices to food prices. We examined food system vulnerability to rising oil prices and the publichealth consequences. In the short term, high food prices harm food security and equity. Over time, high prices will force the entire food system to adapt. Strong preparation and advance investment may mitigate the extent of dislocation and hunger. Certain social and policy changes could smooth adaptation; publichealth has an essential role in promoting a proactive, smart, and equitable transition that increases resilience and enables adequate food for all.

In the past, mentoring was the job of one senior researcher in which the mentor molded the mentee in his/her own image. With publichealth being a very multidisciplinary field, mentoring may need to evolve to facilitate the needs of emerging scientists-including epidemiologists. The mentoring relationship can begin at many education stages, including high school. Involving students at all education levels acts as a way to recruit and nurture interest in publichealth. On the basis of the experience in the medical sciences, mentoring programs also can be used to recruit and retain high-quality professionals in our discipline. Mentoring functions nurture a young mentee with the bonus of greater workplace satisfaction for the mentor. Nevertheless, more understanding of what constitutes successful mentoring and how to develop programs that create great mentors is needed.

The number of people who have limited access to high-quality water has increased, and while this is a growing global crisis, water issues, problems and solutions are often seen as localised. Water reuse and reclamation will play a significant role in achieving sustainability and publichealth protection in the future. The wastewater and reuse community should be responsible for monitoring sewage impacts and improvements as demonstrated through pathogen reduction with appropriate treatment. Viruses, Cryptosporidium and Giardia can all be reduced during treatment anywhere from 99% to 99.9999%, achieving drinking water quality, if so desired. Recommendations to achieve better access to scientific information for decision making include: 1) developing a global data base for biological contaminant loading from wastewater and 2) defining the publichealth protection via reuse and reclamation.

This article describes the introduction of quality improvement actions in a publichealth organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users' opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on publichealth services subject to external audit or certification.

Competition for resources between or within nations is likely to become an increasingly common cause of armed conflict. Competition for petroleum is especially likely to trigger armed conflict because petroleum is a highly valuable resource whose supply is destined to contract. Wars fought over petroleum and other resources can create publichealth concerns by causing morbidity and mortality, damaging societal infrastructure, diverting resources, uprooting people, and violating human rights. Publichealth workers and the organizations with which they are affiliated can help prevent resource wars and minimize their consequences by (1) promoting renewable energy and conservation, (2) documenting the impact of past and potential future resource wars, (3) protecting the human rights of affected noncombatant civilian populations during armed conflict, and (4) developing and advocating for policies that promote peaceful dispute resolution. PMID:21778501

Peak oil is the phenomenon whereby global oil supplies will peak, then decline, with extraction growing increasingly costly. Today's globalized industrial food system depends on oil for fueling farm machinery, producing pesticides, and transporting goods. Biofuels production links oil prices to food prices. We examined food system vulnerability to rising oil prices and the publichealth consequences. In the short term, high food prices harm food security and equity. Over time, high prices will force the entire food system to adapt. Strong preparation and advance investment may mitigate the extent of dislocation and hunger. Certain social and policy changes could smooth adaptation; publichealth has an essential role in promoting a proactive, smart, and equitable transition that increases resilience and enables adequate food for all. PMID:21778492

Publichealth decision-making is critically dependent on the timely availability of sound data. The role of health information systems is to generate, analyse and disseminate such data. In practice, health information systems rarely function systematically. The products of historical, social and economic forces, they are complex, fragmented and unresponsive to needs. International donors in health are largely responsible for the problem, having prioritized urgent needs for data over longer-term country capacity-building. The result is painfully apparent in the inability of most countries to generate the data needed to monitor progress towards the Millennium Development Goals. Solutions to the problem must be comprehensive; money alone is likely to be insufficient unless accompanied by sustained support to country systems development coupled with greater donor accountability and allocation of responsibilities. The Health Metrics Network, a global collaboration in the making, is intended to help bring such solutions to the countries most in need. PMID:16184276

Violence--homicides, suicides, injuries caused by youth or family acts--continues in the United States. Firearms are involved in most incidents. The Centers for Disease Control and Prevention addresses the problem using the traditional tools of publichealth: epidemiologic data, individual and societal interventions based on the data, and ongoing evaluations to assess the effects of the interventions and change them if necessary. Examples of interventions are presented. PMID:7581313

The resurgence of Zika virus as publichealth emergency of an international concern with increased incidence of microcephaly has drawn attention of scientific community for its detailed understanding with regard to virus evolution, epidemiology, geographical spread, pathogenesis, etc. The scope of the present review is to discuss the detailed updated information in respect of Zika virus evolution since its inception. This article is protected by copyright. All rights reserved.

The fact that a third of all African Americans now live in suburbs might suggest how far we have come since the pre-Brown days. But most African Americans live in predominantly Black suburbs, where property values are lower than in neighboring White suburbs, and where the public schools are funded by a lower tax base. After presenting a national…

Summarizing the findings of a longitudinal study of public and private schooling recently published, this paper provides evidence relevant to proposals that would either increase or decrease the role of private schools in American education. The authors specifically address eight premises that would increase the role of private schools and seven…

September 11 2001 attacks and following Anthrax mailings introduced emergent need for developing technologies that can distinguish between man made and natural incidents in the publichealth level. With this objective in mind, government agencies started a funding effort to foster the design, development and implementation of such systems on a wide scale. But the outcomes have not met the expectations set by the resources invested. Multiple elements explain this phenomenon: As it has been frequent with technology, introduction of new surveillance systems to the workflow equation has occurred without taking into consideration the need for understanding and inclusion of deeper personal, psychosocial, organizational and methodological concepts. The environment, in which these systems are operating, is complex, highly dynamic, uncertain, risky, and subject to intense time pressures. Such 'difficult' environments are very challenging to the human as a decision maker. In this paper we will challenge these systems from the perspective of human factors design. We will propose employment of systematic situational awareness research for design and implementation of the next generation publichealth preparedness infrastructures. We believe that systems designed based on results of such analytical definition of the domain enable publichealth practitioners to effectively collect the most important cues from the environment, process, interpret and understand the information in the context of organizational objectives and immediate tasks at hand, and use that understanding to forecast the short term and long term impact of the events in the safety and well being of the community.

A brief review of the career of the publichealth physician Walter Sidney Pereira Leser, who died in 2004 aged 94. Self-taught, from his 1933 doctoral thesis he became a country reference in the field of statistics and epidemiology, with dozens of studies and supervisions. In the clinical field he is one of the founders of Fleury Laboratory, and participates in the creation of CREMESP. As an academic, Leser was a professor at the Escola de Sociologia e Política de São Paulo, Escola Paulista de Medicina e Faculdade de Farmácia e Odontologia da USP. Also, Leser introduced objective tests in the college entrance examination, and led the creation of CESCEM and Carlos Chagas Foundation. In the Escola Paulista de Medicina he created the first Preventive Medicine Department of the country. As a public official, he was secretary of the State Department of Health of São Paulo between 1967 and 1971 and between 1975 and 1979, responsible for extensive reforms and innovations. Among the most remembered, the creation of sanitary medical career. Throughout this legacy, he lent his name to the "Medal of Honor and Merit PublicHealth Management" of the State of São Paulo.

Global exposures to emerging wireless technologies from applications including mobile phones, cordless phones, DECT phones, WI-FI, WLAN, WiMAX, wireless internet, baby monitors, and others may present serious publichealth consequences. Evidence supporting a publichealth risk is documented in the BioInitiative Report. New, biologically based public exposure standards for chronic exposure to low-intensity exposures are warranted. Existing safety standards are obsolete because they are based solely on thermal effects from acute exposures. The rapidly expanding development of new wireless technologies and the long latency for the development of such serious diseases as brain cancers means that failure to take immediate action to reduce risks may result in an epidemic of potentially fatal diseases in the future. Regardless of whether or not the associations are causal, the strengths of the associations are sufficiently strong that in the opinion of the authors, taking action to reduce exposures is imperative, especially for the fetus and children. Such action is fully compatible with the precautionary principle, as enunciated by the Rio Declaration, the European Constitution Principle on Health (Section 3.1) and the European Union Treaties Article 174.

The two dominating publichealth issues associated with composting are odors and bioaerosols, regardless of the feedstock or method of composting. Odors, per se, are an irritant and a nuisance rather than a direct health problem. However, when odors emanate form a facility, the surrounding public often associates odors with compounds which may result in health problems. For example, hydrogen sulfide is not found in high concentrations during composting or found to be of a health significance in the air surrounding composting facilities, yet health issues related to this compound have emerged as a result of odors. Another health concern associated with odors is bioaerosols. Bioaerosols are biological organisms or substances from biological organisms which have been implicated in human health. Bioaerosols may contain fungal spores, actinomycetes, microbial products, and other organisms. Mitigating odors and bioaerosols is a function of facility design and operations. There is a greater opportunity in municipal solid waste (MSW) and biosolids facilities for effective design than with year waste facilities. MSW and biosolids facilities as a result of the nature of the feedstock generally require more sophisticated materials handling equipment which require enclosures. With enclosures there is a greater opportunity to scrub the air for removal of odors and dust. There are also more regulatory requirements for MSW and sewage sludge composting for both process and product by states and the Federal government. The objective of this paper is to provide information on the concerns, state-of-the-art, and potential mitigating aspects which need to be considered in the design and operation of MSW facilities.

Although it has been of interest to publichealth leaders, advocates, and policy planners for many years, decades have passed since the last organized count of publichealth workers. This article reports on methods used by the Columbia University School of Nursing, Center for Health Policy, to enumerate the publichealth workforce in 57 states and territories based on existing reports, summaries, and surveys. The complexity of publichealth workforce data is described and the scheme utilized to characterize the workforce using public agency categories is illustrated. The resulting "best current estimate" provokes many questions regarding future policy about a publichealth workforce database.

The article examines core elements of the national and international discussion on the required integration between research, policy and practice in publichealth, and provides input for this integration. Some conceptual barriers and other barriers at different spheres that interfere with the desired integration are discussed. Evidence has shown that research, policy and practice in health are not continuous, homogenous areas but rather involve different levels and actors. Their processes develop in different grounds supported by a variety of actions, paradigms and interests that are not conflict-free. Thus, this integration is a major challenge given its complexity and multiplicity of objective and subjective aspects.

Importance Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients. Objective To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma. Data Sources MEDLINE, EMBASE, and CINAHL (from 2006–2012) were searched for studies evaluating health outcome after traumatic injuries. Study selection and data extraction Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts. Results 34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%). Conclusion Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care. PMID:25051353

Tourism has been steadily expanding in recent years and continues to do so, with the result that the health and social problems related to this new mass phenomenon are growing likewise. Urgent and serious attention to the various implications is now required on the part of relevant national and international bodies and of all sectors interested in the health and wellbeing of tourists, both in their place of origin and at their destination. Tourist health is a new branch of publichealth concerned with the protection and promotion of the health of tourists. The traditional role of medicine has always been to deal with the health aspects of the most important of life's activities, such as work and sport. The medical profession cannot therefore neglect a leisure-time pursuit such as tourism, in view of its wide-ranging health implications. The Italian Association for Tourist Medicine (IATM) and the Tourist Health Centre, with headquarters in Rimini, were founded in 1983 to assist in the creation of tourist health as a discipline and to promote its development. An international meeting on Prevention and control of infections in tourists in the Mediterranean area, organized in close collaboration with the World Health Organization (WHO) and the World Tourism Organization (WTO) was held in Rimini on 8-11 February 1988. The meeting recommended that the IATM act as focal point in the promotion of tourist health and tourist medicine, especially for countries in the Mediterranean area. In December 1988, the Tourist Health Centre, Rimini was designated as a WHO collaborating centre for tourist health and tourist medicine.(ABSTRACT TRUNCATED AT 250 WORDS)

Objective: To investigate whether private foundations can be created in a way that will insulate them from attacks by the tobacco industry, using the Minnesota Partnership for Action Against Tobacco (MPAAT) as a case study. Design: Information was collected from internal tobacco industry documents, court documents, newspapers, and interviews with health advocates and elected officials. Results: The creation of MPAAT as an independent foundation did not insulate it from attacks by tobacco industry allies. During 2001–2002, MPAAT was repeatedly attacked by Attorney General Mike Hatch and major media, using standard tobacco industry rhetoric. This strategy of attack and demands for information were reminiscent of previous attacks on Minnesota's Plan for Nonsmoking and Health and the American Stop Smoking Intervention Study (ASSIST). MPAAT was ultimately forced to restructure its programme to abandon effective community norm change interventions around smoke-free policies and replace them with less effective individual cessation interventions. Neither MPAAT nor other health advocates mounted an effective public response to these attacks, instead relying on the insider strategy of responding in court. Conclusion: It is not possible to avoid attacks by the tobacco industry or its political allies. Like programmes administered by government agencies, tobacco control foundations must be prepared for these attacks, including a proactive plan to educate the public about the principles of community based tobacco control. Publichealth advocates also need to be willing to take prompt action to defend these programmes and hold public officials who attack tobacco control programmes accountable for their actions. PMID:15333877

Health promotion is one of the essential functions of publichealth authorities. The first pillar of health promotion is the elaboration of healthy public policy. Using the theoretical foundations of the healthy public policy concept, it can be demonstrated that publichealth authorities are able to develop, at their own scale, healthy public policies. Three strategic approaches are proposed in order to support publichealth authorities in strengthening their healthy public policy actions. First, better understand the tools or policy instruments (economic, regulation, information and persuasion) at their disposal. Second, take stock of the many types of legitimacy (theoretical, legislative, administrative and scientific) available to publichealth authorities as they develop healthy public policy. Third, consider the potential scientific roles that can be adopted while using the various policy instruments. These approaches can represent a pragmatic and structuring support for publichealth authorities wanting to strengthen their healthy public policy actions.

In order to better understand the effects of student-life stress on Education and Health Service majors (n = 195) at a private, religious, Midwestern university in the USA, we assessed student perception of overall stress level and physical stress level using the Student-life Stress Inventory. The targeted sample consisted of students with…

Premature birth (defined as delivery before 37 weeks gestation) and low birthweight (below 2,500 grams) are majorhealth problems in the United States. Infants in these categories account for 75 per cent of neonatal deaths and 50 per cent of deaths in the first year of life. Survivors contribute disproportionately to the pool of handicapped…

A personnel management problem exists within dental publichealth that interferes with its mission of improving the nation's oral health. A major cause of this problem may be that many administrators who write position descriptions and hire professional staff are unaware of differences between clinical and publichealth dental practitioners. A marketing plan has been developed to address this lack of awareness about proper use of dental publichealth professionals. Its main goal is to establish more appropriate personnel and employment practices within dental publichealth. The expected outcomes of this plan could assist both recipients of dental publichealth services and members of the profession. The purpose of this article is to introduce the marketing strategy to dental publichealth professionals.

This paper will argue that the UK has seen several phases of publichealth improvement since the Industrial Revolution, and that each of these can be linked to major shifts in thinking about the nature of society and health itself. The authors are not, however, attempting to delineate firm sequences of events (or imply causality) as this would require a level of analysis of the relationship between economy, society and culture which is beyond the scope of this paper. Rather, it is suggested that each phase of health improvement can be thought of in metaphorical terms as a 'wave'. The first wave is associated with great public works and other developments arising from social responses to the profound disruptions which followed the Industrial Revolution. The second wave saw the emergence of medicine as science. The third wave involved the redesign of our social institutions during the 20th Century and gave birth to the welfare state. The fourth wave has been dominated by efforts to combat disease risk factors and the emergence of systems thinking. Although a trough of publichealth activity continues from each wave, none exerts the same impact as when it first emerged. This paper will discuss the complex challenges of obesity, inequality and loss of wellbeing, together with the broader problems of exponential growth in population, money creation and energy usage. As exponential growth is unsustainable on a finite planet, inevitable change looms. Taken together, these analyses suggest that a fifth wave of publichealth development is now needed; one which will need to differ radically from its forerunners. The authors invite others to join them in envisioning its nature and in furthering the debate about future publichealth.

This study explored health organizations' public relations efforts to frame health issues through their press releases. Content analysis of 316 press releases from three health organizations-the American Heart Association, the American Cancer Society, and the American Diabetes Association-revealed that they used the medical research frame most frequently and emphasized societal responsibility for health issues. There were differences, however, among the organizations regarding the main frames and health issues: the American Diabetes Association was more likely to focus on the issues related to social support and education, while the American Heart Association and the American Cancer Society were more likely to address medical research and scientific news. To demonstrate their initiatives for publichealth, all the organizations employed the social support/educational frame most frequently. Researchers and medical doctors frequently were quoted as trusted sources in the releases.

This article describes the most recent efforts by the Quad Council of PublicHealth Nursing organizations to review and revise the competencies for PHN practice, and highlights the implications of these competencies for practice, education, and research. The Quad Council is a coalition of four nursing organizations with a focus on publichealth nursing and includes the Association of Community Health Nursing Educators; the Association of PublicHealth Nursing (known prior to July 1, 2012 as the Association of State and Territorial Directors of Nursing); the PublicHealth Nursing section of the American PublicHealth Association; and the Council on Economics and Practice of the American Nurses' Association. The Quad Council competencies are based on the Council on Linkages competencies for publichealth professionals and were designed to ensure that publichealth nursing fits in the domain of publichealth science and practice.

Engineering is the application of scientific and technical knowledge to solve human problems. Using imagination, judgment, and reasoning to apply science, technology, mathematics, and practical experience, engineers develop the design, production, and operation of useful objects or processes. During the 1940s, engineers dominated the ranks of CDC scientists. In fact, the first CDC director, Assistant Surgeon General Mark Hollis, was an engineer. CDC engineers were involved in malaria control through the elimination of standing water. Eventually the CDC mission expanded to include prevention and control of dengue, typhus, and other communicable diseases. The development of chlorination, water filtration, and sewage treatment were crucial to preventing waterborne illness. Beginning in the 1950s, CDC engineers began their work to improve publichealth while developing the fields of environmental health, industrial hygiene, and control of air pollution. Engineering disciplines represented at CDC today include biomedical, civil, chemical, electrical, industrial, mechanical, mining, and safety engineering. Most CDC engineers are located in the National Institute for Occupational Safety and Health (NIOSH) and the Agency for Toxic Substances and Disease Registry (ATSDR). Engineering research at CDC has a broad stakeholder base. With the cooperation of industry, labor, trade associations, and other stakeholders and partners, current work includes studies of air contaminants, mining, safety, physical agents, ergonomics, and environmental hazards. Engineering solutions remain a cornerstone of the traditional "hierarchy of controls" approach to reducing publichealth hazards.

The prejudicial linking of infection with ethnic minority status has a long-established history, but in some ways this association may have intensified under the contemporary circumstances of the "new publichealth" and globalization. This study analyzes this conflation of ethnicity and disease victimization by considering the stigmatization process that occurred during the 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) in Toronto. The attribution of stigma during the SARS outbreak occurred in multiple and overlapping ways informed by: (i) the depiction of images of individuals donning respiratory masks; (ii) employment status in the health sector; and (iii) Asian-Canadian and Chinese-Canadian ethnicity. In turn, stigmatization during the SARS crisis facilitated a moral panic of sorts in which racism at a cultural level was expressed and rationalized on the basis of a rhetoric of the new publichealth and anti-globalization sentiments. With the former, an emphasis on individualized self-protection, in the health sense, justified the generalized avoidance of those stigmatized. In relation to the latter, in the post-9/11 era, avoidance of the stigmatized other was legitimized on the basis of perceiving the SARS threat as a consequence of the mixing of different people predicated by economic and cultural globalization.

1. The aims of the present paper are to: (i) review progress in clinical toxicology over the past 40 years and to place it in the context of modern health care by describing its development; and (ii) illustrate the use of clinical toxicology data from Scotland, in particular, as a tool for informing clinical care and publichealth policy with respect to drugs. 2. A historical literature review was conducted with amalgamation and comparison of a series of published and unpublished clinical toxicology datasets from NPIS Edinburgh and other sources. 3. Clinical databases within poisons treatment centres offer an important method of collecting data on the clinical effects of drugs in overdose. These data can be used to increase knowledge on drug toxicity mechanisms that inform licensing decisions, contribute to evidence-based care and clinical management. Combination of this material with national morbidity datasets provides another valuable approach that can inform publichealth prevention strategies. 4. In conclusion, clinical toxicology datasets offer clinical pharmacologists a new study area. Clinical toxicology treatment units and poisons information services offer an important health resource.

Soil is the most complicated biomaterial on the planet due to complex soil architecture and billions of soil microbes with extreme biotic diversity. Soil is potentially a source of human pathogens, which can be defined as geo-indigenous, geo-transportable, or geotreatable. Such pathogens cumulatively can and do result in multiple human fatalities annually. A striking example is Helminths, with current infections worldwide estimated to be around two billion. However, soil can also be a source of antibiotics and other natural products that enhance human health. Soilborne antibiotics are used to treat human infections, but can also result in antibiotic-resistant bacteria. Natural products isolated from soil resulted in 60% of new cancer drugs between the period 1983–1994. Soils are also crucial to human health through their impact on human nutrition. Finally, from a global perspective, soils are vital to the future well-being of nations through their impact on climate change and global warming. A critical review of soil with respect to publichealth leads to the conclusion that overall soil is a publichealth savior. The value of soil using a systems approach is estimated to be $20 trillion, and is by far the most valuable ecosystem in the world.

Non-communicable diseases (NCD) are a major and increasing contributor to morbidity and mortality in developed and developing countries. Much of the chronic disease burden is preventable through modification of lifestyle behaviours, and increased attention is being focused on identifying and implementing effective preventative health strategies. Nutrition has been identified as a major modifiable determinant of NCD. The recent merging of health economics and nutritional sciences to form the nascent discipline of nutrition economics aims to assess the impact of diet on health and disease prevention, and to evaluate options for changing dietary choices, while incorporating an understanding of the immediate impacts and downstream consequences. In short, nutrition economics allows for generation of policy-relevant evidence, and as such the discipline is a crucial partner in achieving better population nutritional status and improvements in publichealth and wellness. The objective of the present paper is to summarise presentations made at a satellite symposium held during the 11th European Nutrition Conference, 28 October 2011, where the role of nutrition and its potential to reduce the publichealth burden through alleviating undernutrition and nutrition deficiencies, promoting better-quality diets and incorporating a role for functional foods were discussed.

This article examines the nature and role of Web 2.0 resources and their impact on health information made available though the Internet. The transition of the Web from version one to Web 2.0 is described and the main features of the new Web examined. Two characteristic Web 2.0 resources are explored and the implications for the public and practitioners examined. First, what are known as 'user reviews' or 'user testimonials', which allow people to comment on the health services delivered to them, are described. Second, new mapping applications that take advantage of the interactive potential of Web 2.0 and provide tools to visualize complex data are examined. Following a discussion of the potential of Web 2.0, it is concluded that it offers considerable opportunities for disseminating health information and creating new sources of data, as well as generating new questions and dilemmas.

Social media monitoring for publichealth emergency response and recovery is an essential response capability for any health department. The value of social media for emergency response lies not only in the capacity to rapidly communicate official and critical incident information, but as a rich source of incoming data that can be gathered to inform leadership decision-making. Social media monitoring is a function that can be formally integrated into the Incident Command System of any response agency. The approach to planning and required resources, such as staffing, logistics, and technology, is flexible and adaptable based on the needs of the agency and size and scope of the emergency. The New York City Department of Health and Mental Hygiene has successfully used its Social Media Monitoring Team during publichealth emergency responses and planned events including major Ebola and Legionnaires' disease responses. The concepts and implementations described can be applied by any agency, large or small, interested in building a social media monitoring capacity. (Disaster Med PublicHealth Preparedness. 2016;page 1 of 6).

The IOM's 2003 report Who Will Keep the Public Healthy? recommended that "...all undergraduates should have access to education in publichealth." They justified their recommendations stating that "publichealth is an essential part of the training of citizens." The IOM recommendations have catalyzed a movement linking undergraduate publichealth education with arts and sciences' Liberal Education and America's Promise (LEAP), an initiative designed to produce an educated citizenry. Schools and programs in publichealth rapidly adopted the IOM recommendations and efforts to reach the other 1900 4-year colleges and universities are now underway. A November 2006 Consensus Conference on Undergraduate PublicHealth Education brought together publichealth, arts and science, and clinical health professions educators. The recommendations of the Consensus Conference supported the development of core undergraduate publichealth curricula designed to fulfill general education requirement in institutions with and without graduate publichealth education. Minors built upon required core curricula, utilizing faculty and institution strengths, and providing opportunities for experiential learning such as service-learning were encouraged. A curriculum guide, faculty development program, and multiple presentations, websites, and publications have sought to implement these recommendations. The IOM has recently approved a multi-year Roundtable on Undergraduate PublicHealth Education to help develop the strategies and collaboration needed to bring these efforts to fruition. Enduring understandings for three core courses-PublicHealth 101, Epidemiology 101, and Global Health 101-are included to help guide the development of undergraduate publichealth education.

Addressing increasing concerns about publichealth equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003.Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Publichealth equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction.Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.

The Agency for Toxic Substances and Disease Registry (ATSDR) is a publichealth agency with responsibility for assessing the publichealth implications associated with uncontrolled releases of hazardous substances into the environment. The biological effects of low-level exposures are a primary concern in these assessments. One of the tools used by the agency for this purpose is the risk assessment paradigm originally outlined and described by the National Academy of Science in 1983. Because of its design and inherent concepts, risk assessment has been variously employed by a number of environmental and publichealth agencies and programs as a means to organize information, as a decision support tool, and as a working hypothesis for biologically based inference and extrapolation. Risk assessment has also been the subject of significant critical review. The ATSDR recognizes the utility of both the qualitative and quantitative conclusions provided by traditional risk assessment, but the agency uses such estimates only in the broader context of professional judgment, internal and external peer review, and extensive public review and comment. This multifaceted approach is consistent with the Council on Environmental Quality's description and use of risk analysis as an organizing construct based on sound biomedical and other scientific judgment in concert with risk assessment to define plausible exposure ranges of concern rather than a single numerical estimate that may convey an artificial sense of precision. In this approach biomedical opinion, host factors, mechanistic interpretation, molecular epidemiology, and actual exposure conditions are all critically important in evaluating the significance of environmental exposure to hazardous substances. As such, the ATSDR risk analysis approach is a multidimensional endeavor encompassing not only the components of risk assessment but also the principles of biomedical judgment, risk management, and risk communication

ABSTRACT This study describes the scientific production on oral health diffused in Revista de Saúde Pública, in the 50 years of its publication. A narrative review study was carried out using PubMed, as it is the search database that indexes all issues of the journal. From 1967 to 2015, 162 manuscripts specifically focused on oral health themes were published. This theme was present in all volumes of the journal, with increasing participation over the years. Dental caries was the most studied theme, constantly present in the journal since its first issue. Periodontal disease, fluorosis, malocclusions, and other themes emerged even before the decline of dental caries indicators. Oral health policy is the most recurring theme in the last two decades. Revista de Saúde Pública has been an important vehicle for dissemination, communication, and reflection on oral health, contributing in a relevant way to the technical-scientific interaction between professionals in this field. PMID:27598787

Farmers' suicide in India is a cause of concern and government figures, though conservative, predict an impending epidemic. Various measures to curb this calamity are being made in a piecemeal manner. Considering it as an issue of social and mental health concern, this article attempts to evaluate the situation based on the tenet that health and illness are the result of a complex interplay between biological, psychological, social, environmental, economic and political factors. Thus in India the agrarian crisis, among other causes, has been largely debated as the major reason for the current state of farmers. It is important that (psychiatric) epidemiology and public mental health try to evolve mechanisms to understand and implement measures, and take this into consideration when attempting health promotion and prevention.

Background: Sustainable Development Goals (SDGs) aim to transform our world, and each goal has specific targets to be achieved by 2030. For the goals to be achieved, everyone needs to do their part: governments, academia, the private sector and all people. This paper summarizes the main evidence-based recommendations made by excellent academics and scholars who discussed their experiences and views during the conference to respond to the challenges of sustainable health development. Methods: To contribute to exploring to the academia’s role in reaching SDGs, the 1st International Conference on Sustainable Health Development was held at Tehran University of Medical Sciences, on 24–25 April 2016, in Tehran, Iran. Results: In line with Goal 3 of SDGs: “ensure healthy lives and promote well-being for all at all ages”, the conference discussed various aspects of Universal Health Coverage (UHC), as well as Global Action Plans for prevention and control of Non-Communicable Diseases (NCDs), and explained the special role of academic publichealth institutes in education, research and service provision in the two above-mentioned areas. Conclusion: To fulfill the requirements of SDGs, modern approaches to funding, education, teaching, research priority setting and advocacy, which in turn need novel strategies in collaboration and constructive partnerships among academic publichealth institutes from low, middle and high-income countries, are essential. PMID:28028502

Today’s publichealth crises, as exemplified by the Ebola outbreak, lead to dramatic calls to action that typically include improved electronic monitoring systems to better prepare for, and respond to, similar occurrences in the future. Even a preliminary publichealth informatics evaluation of the current Ebola crisis exposes the need for enhanced coordination and sharing of trustworthy publichealth intelligence. We call for a consumer-centric model of publichealth intelligence and the formation of a national center to guide publichealth intelligence gathering and synthesis. Sharing accurate and actionable information with government agencies, health care practitioners, policymakers, and, critically, the general public, will mark a shift from doing publichealth surveillance on people to doing publichealth surveillance for people. PMID:26180978

Today's publichealth crises, as exemplified by the Ebola outbreak, lead to dramatic calls to action that typically include improved electronic monitoring systems to better prepare for, and respond to, similar occurrences in the future. Even a preliminary publichealth informatics evaluation of the current Ebola crisis exposes the need for enhanced coordination and sharing of trustworthy publichealth intelligence. We call for a consumer-centric model of publichealth intelligence and the formation of a national center to guide publichealth intelligence gathering and synthesis. Sharing accurate and actionable information with government agencies, health care practitioners, policymakers, and, critically, the general public, will mark a shift from doing publichealth surveillance on people to doing publichealth surveillance for people.

The EPA and the CDC have conducted a collaborative effort entitled the PublicHealth Air Surveillance Evaluation (PHASE) to pilot the development of integrated air quality data sets, from routinely available sources, for specific use by publichealth officials.

Publichealth's promise for the future is inextricably related to efforts which maximize human potential and which realize the world's interdependence. Publichealth challenges are not only constant and complex but frequently surrounded by political activities. In this environment, the publichealth enterprise has been enhanced by the Institute of Medicine, National Academy of Sciences' report on The Future of PublicHealth and the assessment framework it provides. Risk reduction through preventive and health promotion activities is the primary focus of publichealth, but facilitation is often dependent upon society's understanding and willingness-to-pay for such services. The effectiveness of publichealth is related to an ability to coordinate public and private efforts at national, state, and local levels. Also in this environment, publichealth is empowered through its multidisciplinary approach. However, epidemiology provides a unifying framework for the collective publichealth effort. Based on the use of epidemiology, publichealth is empowered to make the argument for a national health program and to support the concept of health as a determinant of life options. Publichealth's promise for the future can be fulfilled by continuing to increase its scientific base for decision-making, by self-examination and correction, by advocating and promoting self-examination and correction, by advocating and promoting social justice and by promoting firm partnerships with the public.

OBJECTIVES. The goal of this study was to provide insight concerning the potential of credentialing publichealth workers through an exploratory examination of publichealth leaders' perceptions. METHODS. Qualitative and quantitative procedures were used. Credentialing issues were identified through the literature and through open-ended interviews with leaders and experts. A 74-item Likert-type survey was used to quantify perceptions. Key informants and survey participants were identified through pertinent organizations. RESULTS. The publichealth leaders leaned toward consensus on some benefits of and concerns about credentialing. There was no consensus related to a specific form of desired credentialing, although national certification was supported by a plurality. State licensing and an emphasis on the master's in publichealth (MPH) degree were opposed by large margins. Publichealth leadership survey results were similar to results of a survey of credentialing experts. CONCLUSIONS. The lack of consensus and the vehemence of some opposing positions indicate that movements toward credentialing should proceed cautiously. However, many of the response patterns indicate that the issue merits further exploration. PMID:7762707

Little information is available on the publichealth workforce. This study contributes to the gap in the literature and examines the demographic characteristics, career destinations and earnings of Masters in PublicHealth (MPH) graduates in Australia, using data from the 1999-2009 waves of the Graduate Destination Survey. It was found that publichealth graduates had a high amount of female representation and very low proportions of indigenous representation. Publichealth graduates experienced a relatively low unemployment rate and 85% were employed within 120 days of graduation. However, close to half of the graduates did not work in the health industry or in health-related roles. The mean salaries of publichealth graduates working in publichealth roles were relatively low compared to those in other occupations, but they had a range comparable to that observed for publichealth professionals in the USA and were higher than those of other Masters graduates in some other health fields. The results indicate strong demand and positive employment prospects for publichealth graduates in Australia. Strategies to target recruitment and/or retention of female or indigenous graduates in the publichealth workforce should be a priority. Mapping of publichealth graduate destinations and employment prospects should might be prioritised, given its strong potential to facilitate workforce planning and provide potential publichealth workers with more comprehensive career trajectories.

International interest in the social determinants of health and their public policy antecedents is increasing. Despite evidence that the USA presents one of the worst population health profiles and public policy environments in support of health among wealthy developed nations - a result of systemic inequities in income, influence, and power - the USA publichealth gaze is firmly - and narrowly - focused on issues of access to health care, racial and ethnic disparities in healthcare, and individual behavioral risk factors. Reasons for the USA's neglect of structural and public policy issues are explored and Ten Tips for American PublicHealth Researchers and Workers are presented.

CDC joins the American PublicHealth Association (APHA) in celebration of National PublicHealth Week, April 3-9, 2017. Since 1995, APHA has led the observance of National PublicHealth Week during the first full week of April. The week recognizes the impact of publichealth on the health of the nation. The 2017 observance focuses on making the United States the Healthiest Nation in One Generation by 2030 by spotlighting the importance of prevention, employing successful strategies for collaboration, and promoting the critical role of a strong publichealth system.

In the United States, fiscal and functional federalism strongly shape publichealth policy and programs. Federalism has implications for publichealth practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures publichealth funding, policy, and program options, investigating the effects of intergovernmental transfers on publichealth finance and programs.

PHANTOM models logistic functions of national publichealth systems. The system enables publichealth officials to visualize and coordinate options for publichealth surveillance, diagnosis, response and administration in an integrated analytical environment. Users may simulate and analyze system performance applying scenarios that represent current conditions or future contingencies what-if analyses of potential systemic improvements. Publichealth networks are visualized as interactive maps, with graphical displays of relevant system performance metrics as calculated by the simulation modeling components.

Obesity is a majorhealth problem today that grows into a global epidemic. According to the World Health Organization report, 1.5 billion adults were overweight, over 500 million of them were obese, and the prevalence of obesity is expected to rise in the years to come. A similar situation is recorded in Croatia, where there are 25.3% of obese men and 34.1% of obese women. There are multiple factors that cause obesity. Accelerated lifestyle, fast food, unhealthy eating habits and sedentary lifestyle are considered as the major risk factors of overweight and obesity development. Accumulation of fat tissue, especially visceral fat tissue has been demonstrated to be associated with some chronic changes and diseases of different organ systems. Some anthropometric measurements, especially body mass index, waist circumference and waist-to-hip ratio, have been used to diagnose obesity and estimate the health risk. Developing well-structured prevention programs that would encourage people to become aware of obesity as a disease and that imbalanced dietary habits and physical activity are important for obesity prevention and health, is a majorpublichealth challenge.

Climate Change plays a significant role in publichealth. Changes in climate affect weather conditions that we are accustomed to. Increases in the frequency or severity of extreme weather events such as storms could increase the risk of dangerous flooding, high winds, and other direct threats to people and property. Changes in temperature, precipitation patterns, and extreme events could enhance the spread of some diseases. According to studies by EPA, the impacts of climate change on health will depend on many factors. These factors include the effectiveness of a community's publichealth and safety systems to address or prepare for the risk and the behavior, age, gender, and economic status of individuals affected. Impacts will likely vary by region, the sensitivity of populations, the extent and length of exposure to climate change impacts, and society's ability to adapt to change. Transmissions of infectious disease have been associated with social, economic, ecological, health care access, and climatic factors. Some vector-borne diseases typically exhibit seasonal patterns in which the role of temperature and rainfall is well documented. Some of the infectious diseases that have been documented by previous studies, include the correlation between rainfall and drought in the occurrence of malaria, the influence of the dry season on epidemic meningococcal disease in the sub-Saharan African, and the importance of warm ocean waters in driving cholera occurrence in the Ganges River delta in Asia The rise of climate change has been a major concern in the publichealth sector. Climate change mainly affects vulnerable populations especially in developing countries; therefore, it's important that publichealth advocates are involve in the decision-making process in order to provide resources and preventative measures for the challenges that are associated with climate change. The main objective of this study is to assess the vulnerability and impact of climate change

This paper reports on an ethnographic study in Cartagena, Colombia. Over a seven-month fieldwork period, 35 men and 35 women between 15 and 60 years of age discussed the social context of HIV/AIDS through in-depth interviews, life histories and drawing. Participants considered the transgression of traditional gender roles as prescribed by machismo a major risk factor for HIV infection. In addition, they integrated public-health concepts of risk groups with these long-standing constructions of gender roles and sexuality-related stigma to create the notion of 'AIDS carriers'. The bricolage between machismo, publichealth and sexuality-related stigma that participants created and consequent preventive measures (based on an avoidance of sex with people identified as 'AIDS carriers') was a dynamic process in which participants were aware that changes in this particular interpretation of risk were necessary to confront the local epidemic.

I offer a historical examination of a group of malaria motion pictures, a subset of a larger genre of publichealth films. The majority of these more than 100 films were produced or coproduced by American and British agencies or production companies since 1940. The material is divided into 5 chronological periods, which include World War II, the postcolonial or DDT era (1946–1961), and the past 2 decades. The films themselves, I argue, represent a unique record of preventive measures, clinical techniques, and sociocultural biases, all within the context of a history of one of the greatest continuing challenges in publichealth. The malaria films, as a group, represent a large body of work that has not yet been brought together or analyzed as historical sources. PMID:12835178

I offer a historical examination of a group of malaria motion pictures, a subset of a larger genre of publichealth films. The majority of these more than 100 films were produced or coproduced by American and British agencies or production companies since 1940. The material is divided into 5 chronological periods, which include World War II, the postcolonial or DDT era (1946-1961), and the past 2 decades. The films themselves, I argue, represent a unique record of preventive measures, clinical techniques, and sociocultural biases, all within the context of a history of one of the greatest continuing challenges in publichealth. The malaria films, as a group, represent a large body of work that has not yet been brought together or analyzed as historical sources.

Big data (very large data sets) are increasing in an accelerating speed. More and more data is also becoming freely available. This article is an overview of this progress and data sources related to molecular biology and publichealth especially from the Finnish perspective. Finland has several excellent data sources that are currently not used effectively. Big data has already produced major benefits especially in molecular biology, but benefits in publichealth and individual choice are only now being materialised. The paradigm in research may change dramatically, if the effort switches from article production to the production of knowledge crystals, i.e. collaborative data-based answers to research questions. Also the role of a clinician is becoming more like that of a coach.